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Sample records for included wilcoxon rank-sum

  1. Causal inference for Mann-Whitney-Wilcoxon rank sum and other nonparametric statistics.

    Science.gov (United States)

    Wu, P; Han, Y; Chen, T; Tu, X M

    2014-04-15

    The nonparametric Mann-Whitney-Wilcoxon (MWW) rank sum test is widely used to test treatment effect by comparing the outcome distributions between two groups, especially when there are outliers in the data. However, such statistics generally yield invalid conclusions when applied to nonrandomized studies, particularly those in epidemiologic research. Although one may control for selection bias by using available approaches of covariates adjustment such as matching, regression analysis, propensity score matching, and marginal structural models, such analyses yield results that are not only subjective based on how the outliers are handled but also often difficult to interpret. A popular alternative is a conditional permutation test based on randomization inference [Rosenbaum PR. Covariance adjustment in randomized experiments and observational studies. Statistical Science 2002; 17(3):286-327]. Because it requires strong and implausible assumptions that may not be met in most applications, this approach has limited applications in practice. In this paper, we address this gap in the literature by extending MWW and other nonparametric statistics to provide causal inference for nonrandomized study data by integrating the potential outcome paradigm with the functional response models (FRM). FRM is uniquely positioned to model dynamic relationships between subjects, rather than attributes of a single subject as in most regression models, such as the MWW test within our context. The proposed approach is illustrated with data from both real and simulated studies. Copyright © 2013 John Wiley & Sons, Ltd.

  2. Use of rank sum method in identifying high occupational dose jobs for ALARA implementation

    International Nuclear Information System (INIS)

    Cho, Yeong Ho; Kang, Chang Sun

    1998-01-01

    The cost-effective reduction of occupational radiation exposure (ORE) dose at a nuclear power plant could not be achieved without going through an extensive analysis of accumulated ORE dose data of existing plants. It is necessary to identify what are high ORE jobs for ALARA implementation. In this study, the Rank Sum Method (RSM) is used in identifying high ORE jobs. As a case study, the database of ORE-related maintenance and repair jobs for Kori Units 3 and 4 is used for assessment, and top twenty high ORE jobs are identified. The results are also verified and validated using the Friedman test, and RSM is found to be a very efficient way of analyzing the data. (author)

  3. [The relationship between Ridit analysis and rank sum test for one-way ordinal contingency table in medical research].

    Science.gov (United States)

    Wang, Ling; Xia, Jie-lai; Yu, Li-li; Li, Chan-juan; Wang, Su-zhen

    2008-06-01

    To explore several numerical methods of ordinal variable in one-way ordinal contingency table and their interrelationship, and to compare corresponding statistical analysis methods such as Ridit analysis and rank sum test. Formula deduction was based on five simplified grading approaches including rank_r(i), ridit_r(i), ridit_r(ci), ridit_r(mi), and table scores. Practical data set was verified by SAS8.2 in clinical practice (to test the effect of Shiwei solution in treatment for chronic tracheitis). Because of the linear relationship of rank_r(i) = N ridit_r(i) + 1/2 = N ridit_r(ci) = (N + 1) ridit_r(mi), the exact chi2 values in Ridit analysis based on ridit_r(i), ridit_r(ci), and ridit_r(mi), were completely the same, and they were equivalent to the Kruskal-Wallis H test. Traditional Ridit analysis was based on ridit_r(i), and its corresponding chi2 value calculated with an approximate variance (1/12) was conservative. The exact chi2 test of Ridit analysis should be used when comparing multiple groups in the clinical researches because of its special merits such as distribution of mean ridit value on (0,1) and clear graph expression. The exact chi2 test of Ridit analysis can be output directly by proc freq of SAS8.2 with ridit and modridit option (SCORES =). The exact chi2 test of Ridit analysis is equivalent to the Kruskal-Wallis H test, and should be used when comparing multiple groups in the clinical researches.

  4. Use of percentile rank sum method in identifying repetitive high occupational radiation dose jobs in a nuclear power plant

    International Nuclear Information System (INIS)

    Cho, Y.H.; Ko, H.S.; Kim, S.H.; Kang, C.S.; Moon, J.H.; Kim, K.D.

    2004-01-01

    The cost-effective reduction of occupational radiation dose (ORD) at a nuclear power plant could not be achieved without going through an extensive analysis of accumulated ORD data of existing plants. Through the data analysis, it is required to identify what are the jobs of repetitive high ORD at the nuclear power plant. In general the point value method commonly used, over-estimates the role of mean and median values to identify the high ORD jobs which can lead to misjudgment. In this study, Percentile Rank Sum Method (PRSM) is proposed to identify repetitive high ORD jobs, which is based on non-parametric statistical theory. As a case study, the method is applied to ORD data of maintenance and repair jobs at Kori units 3 and 4 that are pressurized water reactors with 950 MWe capacity and have been operated since 1986 and 1987, respectively in Korea. The results were verified and validated, and PRSM has been demonstrated to be an efficient method of analyzing the data. (authors)

  5. Applying Rank Sum Ratio (RSR) to the Evaluation of Feeding Practices Behaviors, and Its Associations with Infant Health Risk in Rural Lhasa, Tibet.

    Science.gov (United States)

    Wang, Zhenjie; Dang, Shaonong; Xing, Yuan; Li, Qiang; Yan, Hong

    2015-12-01

    To evaluate the status of feeding practices and analyze the association between feeding practice and health status among Tibetan infants, a cross-sectional survey of 386 women with children aged under 24 months was conducted in rural areas surrounding Lhasa, Tibet. All participants were selected using simple random sampling and were interviewed face-to-face by trained interviewers. Mothers were interviewed to collect information on their feeding practices. A feeding practices index was created using the rank sum ratio method. Most of the infants had been or were being breastfed at the time of the interview. The feeding practices index was significantly and inversely associated with the prevalence of acute upper respiratory infection, and the odds ratio for the qualified feeding practices index vs. the non-qualified feeding practices index was 0.43 (95% confidence interval: 0.20-0.94). There were no measurable associations observed between acute upper respiratory infection, diarrhea, and the feeding practices index after controlling for selected factors. The method of rank sum ratio provides a flexible way to evaluate feeding practices and is easy to understand. Furthermore, appropriate infant feeding practices might play a protective role in Tibetan infants' health.

  6. Normal Approximations to the Distributions of the Wilcoxon Statistics: Accurate to What "N"? Graphical Insights

    Science.gov (United States)

    Bellera, Carine A.; Julien, Marilyse; Hanley, James A.

    2010-01-01

    The Wilcoxon statistics are usually taught as nonparametric alternatives for the 1- and 2-sample Student-"t" statistics in situations where the data appear to arise from non-normal distributions, or where sample sizes are so small that we cannot check whether they do. In the past, critical values, based on exact tail areas, were…

  7. Exact distribution of a maximally selected Wilcoxon and a new hybrid test of symmetry.

    Science.gov (United States)

    Laska, Eugene; Meisner, Morris; Wanderling, Joseph

    2014-10-30

    Recently, a maximally selected normalized Wilcoxon, whose asymptotic distribution is a Brownian Bridge, was proposed for testing symmetry of a distribution about zero. The test sequentially discards observations whose absolute value is below increasing thresholds. The Wilcoxon is obtained at each threshold, and the maximum is the test statistic. We develop a recursive function for the exact distribution of a modification of the Max Wilcoxon test (MW) and provide critical values and a program for computing the p-value for a sample. A new hybrid test that combines the sign and MW tests is introduced. The power of MW and the new hybrid test are compared with Modarres and Gastwirth's hybrid test (MGH) and the Max McNemar (MM), under the generalized lambda distributions (GLD) family and two normal mixture models. The MW and the new hybrid test outperform the MGH, which is superior to the MM test in the GLD family. In one mixture model, MM is the least powerful test and the remaining three are essentially equivalent. In the second mixture model, when the zero median assumption is nearly valid, the MW test does well; its performance degrades when this assumption is violated. In the latter case, the MM performs better than MW for the same degree of skewness because the MM simultaneously tests both symmetry and zero median. Data from a genetic study of monozygotic twins discordant for major depressive disorder is used to illustrate the new tests. Copyright © 2014 John Wiley & Sons, Ltd.

  8. Wilcoxon signed-rank-based technique for the pulse-shape analysis of HPGe detectors

    Energy Technology Data Exchange (ETDEWEB)

    Martín, S., E-mail: sergiomr@usal.es; Quintana, B.; Barrientos, D.

    2016-07-01

    The characterization of the electric response of segmented-contact high-purity germanium detectors requires scanning systems capable of accurately associating each pulse with the position of the interaction that generated it. This process requires an algorithm sensitive to changes above the electronic noise in the pulse shapes produced at different positions, depending on the resolution of the Ge crystal. In this work, a pulse-shape comparison technique based on the Wilcoxon signed-rank test has been developed. It provides a method to distinguish pulses coming from different interaction points in the germanium crystal. Therefore, this technique is a necessary step for building a reliable pulse-shape database that can be used later for the determination of the position of interaction for γ-ray tracking spectrometry devices such as AGATA, GRETA or GERDA. The method was validated by comparison with a χ{sup 2} test using simulated and experimental pulses corresponding to a Broad Energy germanium detector (BEGe).

  9. An automated approach to Litchfield and Wilcoxon's evaluation of dose–effect experiments using the R package LW1949

    Science.gov (United States)

    Adams, Jean V.; Slaght, Karen; Boogaard, Michael A.

    2016-01-01

    The authors developed a package, LW1949, for use with the statistical software R to automatically carry out the manual steps of Litchfield and Wilcoxon's method of evaluating dose–effect experiments. The LW1949 package consistently finds the best fitting dose–effect relation by minimizing the chi-squared statistic of the observed and expected number of affected individuals and substantially speeds up the line-fitting process and other calculations that Litchfield and Wilcoxon originally carried out by hand. Environ Toxicol Chem 2016;9999:1–4. Published 2016 Wiley Periodicals Inc. on behalf of SETAC. This article is a US Government work and, as such, is in the public domain in the United States of America.

  10. Analisis Kecenderungan Data Hujan di Jawa Timur Menggunakan Metode Mann-Kendal dan Rank-Sum Test

    OpenAIRE

    Indarto; Susanto, Budi; Diniardi, Eka Mustika

    2011-01-01

    This paper describe temporal variability of rainfall data in East Java region and perform trend analysis using Mean-Kendall-Test. Is there any significant trend amongs periods? Time series data from (9) nine pluviometres around the East Java region were exploited. Daily rainfall data from: 01 January 1960 to 31 Decembre 2005 were used as main input for the analysis. Daily, Monthly and Annual data were visualised by means of Exploratory Data Analysis (EDA) and then analysed using Mean-Kendal...

  11. Relationships between body mass index and short-circuit current in human duodenal and colonic mucosal biopsies. Osbak PS, Bindslev N, Hansen MB. Acta Physiol (Oxf). 2011 Jan;201(1):47-53

    DEFF Research Database (Denmark)

    Osbak, Philip Samuel; Bindslev, Niels; Berner-Hansen, Mark

    2011-01-01

    Aim: Retrospectively, to investigate the relationship between body mass index (BMI) and basal electrogenic transport as measured by short-circuit current (SCC) in human duodenal and colonic mucosal biopsies. Methods: The study included biopsies from mucosa of normal appearance in the sigmoid colon...... and >25 kg m)2). Statistical significance was assessed by the unpaired t-test or Wilcoxon rank-sum test. Correlation coefficients were calculated by Pearson product moment correlation. Results: In colonic biopsies, basal SCC (mean standard deviation) was significantly higher in 59 biopsies from 30...

  12. Health related quality of life in patients with actinic keratosis

    DEFF Research Database (Denmark)

    Tennvall, Gunnel Ragnarson; Norlin, J M; Malmberg, I

    2015-01-01

    BACKGROUND: Actinic keratosis (AK) is a common skin condition that may progress to non-melanoma skin cancer (NMSC). The disease may influence Health Related Quality of Life (HRQoL), but studies of HRQoL in patients with AK are limited. The purpose of the study was to analyze HRQoL in patients......-center setting. Dermatologists assessed AK severity and patients completed: Actinic Keratosis Quality of Life Questionnaire (AKQoL), Dermatology Life Quality Index (DLQI), and EQ-5D-5 L including EQ-VAS. Differences between categorical subgroups were tested with Wilcoxon rank-sum test. The relationship between...

  13. Rice methylmercury exposure and mitigation: a comprehensive review

    Science.gov (United States)

    Rothenberg, Sarah E.; Windham-Myers, Lisamarie; Creswell, Joel E.

    2014-01-01

    Rice cultivation practices from field preparation to post-harvest transform rice paddies into hot spots for microbial mercury methylation, converting less-toxic inorganic mercury to more-toxic methylmercury, which is likely translocated to rice grain. This review includes 51 studies reporting rice total mercury and/or methylmercury concentrations, based on rice (Orzya sativa) cultivated or purchased in 15 countries. Not surprisingly, both rice total mercury and methylmercury levels were significantly higher in polluted sites compared to non-polluted sites (Wilcoxon rank sum, price percent methylmercury (of total mercury) did not differ statistically between polluted and non-polluted sites (Wilcoxon rank sum, p=0.35), suggesting comparable mercury methylation rates in paddy soil across these sites and/or similar accumulation of mercury species for these rice cultivars. Studies characterizing the effects of rice cultivation under more aerobic conditions were reviewed to determine the mitigation potential of this practice. Rice management practices utilizing alternating wetting and drying (instead of continuous flooding) caused soil methylmercury levels to spike, resulting in a strong methylmercury pulse after fields were dried and reflooded; however, it is uncertain whether this led to increased translocation of methylmercury from paddy soil to rice grain. Due to the potential health risks, it is advisable to investigate this issue further, and to develop separate water management strategies for mercury polluted and non-polluted sites, in order to minimize methylmercury exposure through rice ingestion.

  14. Rice methylmercury exposure and mitigation: a comprehensive review.

    Science.gov (United States)

    Rothenberg, Sarah E; Windham-Myers, Lisamarie; Creswell, Joel E

    2014-08-01

    Rice cultivation practices from field preparation to post-harvest transform rice paddies into hot spots for microbial mercury methylation, converting less-toxic inorganic mercury to more-toxic methylmercury, which is likely translocated to rice grain. This review includes 51 studies reporting rice total mercury and/or methylmercury concentrations, based on rice (Orzya sativa) cultivated or purchased in 15 countries. Not surprisingly, both rice total mercury and methylmercury levels were significantly higher in polluted sites compared to non-polluted sites (Wilcoxon rank sum, p<0.001). However, rice percent methylmercury (of total mercury) did not differ statistically between polluted and non-polluted sites (Wilcoxon rank sum, p=0.35), suggesting comparable mercury methylation rates in paddy soil across these sites and/or similar accumulation of mercury species for these rice cultivars. Studies characterizing the effects of rice cultivation under more aerobic conditions were reviewed to determine the mitigation potential of this practice. Rice management practices utilizing alternating wetting and drying (instead of continuous flooding) caused soil methylmercury levels to spike, resulting in a strong methylmercury pulse after fields were dried and reflooded; however, it is uncertain whether this led to increased translocation of methylmercury from paddy soil to rice grain. Due to the potential health risks, it is advisable to investigate this issue further, and to develop separate water management strategies for mercury polluted and non-polluted sites, in order to minimize methylmercury exposure through rice ingestion. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Pump apparatus including deconsolidator

    Energy Technology Data Exchange (ETDEWEB)

    Sonwane, Chandrashekhar; Saunders, Timothy; Fitzsimmons, Mark Andrew

    2014-10-07

    A pump apparatus includes a particulate pump that defines a passage that extends from an inlet to an outlet. A duct is in flow communication with the outlet. The duct includes a deconsolidator configured to fragment particle agglomerates received from the passage.

  16. Optical modulator including grapene

    Science.gov (United States)

    Liu, Ming; Yin, Xiaobo; Zhang, Xiang

    2016-06-07

    The present invention provides for a one or more layer graphene optical modulator. In a first exemplary embodiment the optical modulator includes an optical waveguide, a nanoscale oxide spacer adjacent to a working region of the waveguide, and a monolayer graphene sheet adjacent to the spacer. In a second exemplary embodiment, the optical modulator includes at least one pair of active media, where the pair includes an oxide spacer, a first monolayer graphene sheet adjacent to a first side of the spacer, and a second monolayer graphene sheet adjacent to a second side of the spacer, and at least one optical waveguide adjacent to the pair.

  17. Factors associated with the lack of antiretroviral therapy initiation ...

    African Journals Online (AJOL)

    positive perception). Scores for harms of ART, stigma and need for ART were reversed so that values closer to 5 indicate less harm and stigma; and greater need for ART. †Mann-Whitney (Wilcoxon rank-sum) test. Table 4. Interpersonal factors.

  18. Topographic Anterograde and Retrograde Memory for Spatial ...

    African Journals Online (AJOL)

    The Mann Whitney U test and Wilcoxon Rank sum statistics were used for data analysis. The findings showed significant differences between retrograde group: before injection and after injection on time spent to run the maze. Similarly significant difference was seen between the retrograde group (before injection) and ...

  19. Validity of early MRI structural damage end points and potential impact on clinical trial design in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Baker, Joshua F; Conaghan, Philip G; Emery, Paul

    2016-01-01

    Wilcoxon rank sum tests and tests of proportion estimated the sample size required to detect differences between combination therapy (methotrexate+golimumab) and methotrexate-monotherapy arms in (A) change in damage score and (B) proportion of patients progressing. RESULTS: Patients with early MRI...

  20. Mean Diffusional Kurtosis in Patients with Glioma

    DEFF Research Database (Denmark)

    Tietze, A.; Hansen, Mikkel Bo; Østergaard, Leif

    2015-01-01

    , and the contralateral normal appearing white and grey matter of 34 patients (22 high-grade, 12 low-grade gliomas). MK’ and MD in different grades were compared using a Wilcoxon rank-sum test. Receiver Operating Characteristic curves and the area under the curve were calculated to determine the diagnostic accuracy of MK...

  1. The effect of pulmonary tuberculosis on neurocognitive function in ...

    African Journals Online (AJOL)

    To examine group differences in neurocognitive status, we used Wilcoxon ranked sum tests to compare the performance between groups on neuropsychological test battery. Results: Out of 324, only 244 were studied. Results indicated significant neurocognitive impairment in PTB+/HIV+ group than PTB-/HIV+ in the GDS, ...

  2. Effect of upper costal and costo-diaphragmatic breathing types on electromyographic activity of respiratory muscles.

    Science.gov (United States)

    Celhay, Isabel; Cordova, Rosa; Miralles, Rodolfo; Meza, Francisco; Erices, Pia; Barrientos, Camilo; Valenzuela, Saúl

    2015-04-01

    To compare electromyographic (EMG) activity in young-adult subjects with different breathing types. This study included 50 healthy male subjects with complete natural dentition, and no history of orofacial pain or craniomandibular-cervical-spinal disorders. Subjects were classified into two groups: upper costal breathing type, and costo-diaphragmatic breathing. Bipolar surface electrodes were located on sternocleidomastoid, diaphragm, external intercostal, and latissimus dorsi muscles. Electromyographic activity was recorded during the following tasks: (1) normal quiet breathing; (2) speaking the word 'Mississippi'; (3) swallowing saliva; and (4) forced deep breathing. Sternocleidomastoid and latissimus dorsi EMG activity was not significantly different between breathing types, whereas diaphragm and external intercostal EMG activity was significantly higher in the upper costal than costo-diaphragmatic breathing type in all tasks (P<0·05; Wilcoxon signed rank-sum test). Diaphragm and external intercostal EMG activity suggests that there could be differences in motor unit recruitment strategies depending on the breathing type.

  3. [Reducing maternal parenting stress of children with autism spectrum disorder: father's involvement].

    Science.gov (United States)

    Hu, C C; Li, Y; Zhou, B R; Liu, C X; Li, C Y; Zhang, Y; Xu, Q; Xu, X

    2017-05-04

    Objective: To explore the relationship between fathers' nursing time and maternal parenting stress of children with autism spectrum disorder(ASD). Method: Mothers of 98 ASD children who were first diagnosed in the department of Child Health Care, Children's Hospital of Fudan University during June 2015 to January 2016 were included in the ASD group, with mothers of 92 typical children from a Community Maternal and Child Health Hospital and a kindergarten in the control group. The evaluation of parenting stress, parents' nursing time and other related factors were cross-sectionally analyzed. Interview was conducted with the following tools: Parental Stress Index-Short Form(PSI-SF)for maternal parenting stress, and self-made General Parenting Information Questionnaire for nursing time of both parents and other related factors. The relationships were analyzed by Multiple Linear Regression analysis and Wilcoxon Rank-Sum test. Result: Maternal parenting stress of ASD children had a significant negative correlation with father's nursing time in total score of parenting stress, PCDI domain and PD domain ( t =-2.76, -2.98, -2.79; P =0.007, 0.004, 0.006), within which PD domain also included family annual income and mothers' nursing time ( R (2)=0.22, 0.24, 0.25); while no such correlation was found in control group in terms of father's nursing time( P =0.22, 0.42, 0.06). Wilcoxon Rank-Sum test showed that in 62 (63.3%) double-income ASD families and 72(78.3%) double-income typical families, there were significant differences between ASD fathers' and ASD mothers'and typical fathers'nursing time(2.0(0.5, 2.1) vs . 3.5(2.4, 6.0) vs . 3.0(2.0, 4.7)h, t =-86.32、-49.65, all P parenting stress and improve the intervention pattern of ASD children.

  4. Relationship between aneurysm wall enhancement and conventional risk factors in patients with unruptured intracranial aneurysms: A black-blood MRI study.

    Science.gov (United States)

    Liu, Peng; Qi, Haikun; Liu, Aihua; Lv, Xianli; Jiang, Yuhua; Zhao, Xihai; Li, Rui; Lu, Bing; Lv, Ming; Chen, Huijun; Li, Youxiang

    2016-10-01

    Aneurysmal wall enhancement (AWE) has emerged as a new possible biomarker for depicting inflammation of the intracranial aneurysm (IA). However, the relationships of AWE with other risk factors are still unclear for unruptured IA. The purpose of this study was to investigate the association between AWE and other risk metrics. Forty-eight patients with unruptured saccular IAs diagnosed by digital subtraction angiography were recruited to undergo magnetic resonance (MR) black-blood imaging. AWE was evaluated using the pre- and post-contrast black-blood MR images. Univariate and multivariate logistic regression analysis was performed to investigate the association of AWE with other risk factors, including size, maximal neck width, parent vessel diameter, location, multiplicity, daughter sacs and other clinical factors. The prevalence of AWE in each ISUIA grade was reported and compared by Wilcoxon rank sum test. In total, 61 aneurysms were detected in 48 patients. Aneurysm size was found to be an independent risk factor associated with AWE (OR 2.46 per mm increase, 95% CI 1.34-4.51; p = 0.004). Patient age was independently and inversely associated with AWE (OR 0.898 per year increase, 95% CI 0.812-0.994; p = 0.037). Higher prevalence of AWE was observed in larger aneurysms (12%, 71.4%, 100%, and 100% of ISUIA grade 1-4 IAs have AWE, respectively). Notably, 12% of small IAs (size <7 mm) exhibited AWE. The IAs with AWE had significant higher ISUIA grade than the IAs without (p < 0.001, Wilcoxon rank sum test). The wall enhancement in contrast-enhanced black-blood MR images was independently associated with aneurysm size in unruptured IAs. However, some small unruptured aneurysms did exhibit wall enhancement, suggesting that AWE may provide additional aneurysm instability information to improve current size-based rupture risk evaluation metrics. © The Author(s) 2016.

  5. (including travel dates) Proposed itinerary

    Indian Academy of Sciences (India)

    Ashok

    31 July to 22 August 2012 (including travel dates). Proposed itinerary: Arrival in Bangalore on 1 August. 1-5 August: Bangalore, Karnataka. Suggested institutions: Indian Institute of Science, Bangalore. St Johns Medical College & Hospital, Bangalore. Jawaharlal Nehru Centre, Bangalore. 6-8 August: Chennai, TN.

  6. Malignant lymphomas (including myeloproliferative disorders)

    International Nuclear Information System (INIS)

    Todd, I.D.H.

    1985-01-01

    This chapter deals with the radiotherapy and cytotoxic chemotherapy of the malignant lymphomas. Included within this group are Hodgkin's disease, non-Hodgkin's lymphoma, mycosis fungoides, and chronic lymphatic leukaemia. A further section deals with the myeloproliferative disorders, including granulocytic leukaemia, polycythaemia vera, and primary thrombocythaemia. Excluded are myeloma and reticulum cell sarcoma of bone and acute leukaemia. With regard to Hodgkin's disease, the past 25 years have seen general recognition of the curative potential of radiotherapy, at least in the local stages, and, more recently, awareness of the ability to achieve long-term survival after combination chemotherapy in generalised or in recurrent disease. At the same time the importance of staging has become appreciated and the introduction of procedures such as lymphography, staging laparotomy, and computer tomography (CT) has enormously increased its reliability. Advances have not been so dramatic in the complex group of non-Hodgkins's lymphomas, but are still very real

  7. Device including a contact detector

    DEFF Research Database (Denmark)

    2011-01-01

    The present invention relates to a probe for determining an electrical property of an area of a surface of a test sample, the probe is intended to be in a specific orientation relative to the test sample. The probe may comprise a supporting body defining a first surface. A plurality of cantilever...... of cantilever arms (12) contacting the surface of the test sample when performing the movement....... arms (12) may extend from the supporting body in co-planar relationship with the first surface. The plurality of cantilever arms (12) may extend substantially parallel to each other and each of the plurality of cantilever arms (12) may include an electrical conductive tip for contacting the area...

  8. Video-based versus Medical Personnel-led Training for the Knowledge on Condom Use, Partner Notification and Sexually Transmitted Infections in Rural Communities in Thailand: A Randomized Comparison Pilot Study

    Directory of Open Access Journals (Sweden)

    Nut Kittipongphat

    2017-09-01

    Full Text Available Objective: To compare the knowledge regarding partner notification (PN, condom use (CU and sexually transmitted infections (STIs after video-based or medical personnel-led training. Methods: From December 2016 to January 2017, we conducted an opened-label randomized study in four communities (20 participants/ community in Bangsaphannoi district, Prachuabkirikhan province. In each community, the participants were randomly allocated into Group A (medical personnel-led training or Group B (video-based training. Both trainings covered similar contents which included knowledge about STIs (5 minutes; how to safely notify their partners (10 minutes and techniques of correct condom use (10 minutes. Participants’ knowledge was assessed by five one-best questions for each topic before and after the training. Comparison of scores within group and between groups was done by using Wilcoxon rank sum test and Wilcoxon signed rank test. P <0.05 was considered statistically significant. Results: From 160 eligible participants, 148 could complete the study (74 in Group A and 74 in Group B. Between two groups, there was no difference of participants’ characteristics, including age, education, employment, sex debut, STIs and number of partners. Both training techniques significantly improved participants’ knowledge and there was no difference between them. The lowest median score and least improvement of knowledge were found in PN. Conclusion: At the community level, both video-based training and medical personnel-led training improve the knowledge on PN, CU and STIs with comparable results.

  9. The effects of Lactobacillus reuteri probiotics combined with azithromycin on peri-implantitis: A randomized placebo-controlled study.

    Science.gov (United States)

    Tada, Hiroaki; Masaki, Chihiro; Tsuka, Shintaro; Mukaibo, Taro; Kondo, Yusuke; Hosokawa, Ryuji

    2018-01-01

    The aim of this randomized placebo-controlled clinical study was to investigate the effects of a probiotic tablet containing Lactobacillus reuteri in peri-implantitis patients. Subjects comprised 30 patients with mild to moderate peri-implantitis. A baseline clinical examination and microbiological assessment were conducted, followed by an antibiotics treatment (azithromycin, 500mg, once a day for 3 days). Subjects were divided into probiotic and placebo groups. The clinical examination and bacterial sampling were performed 0, 4, 12 and 24 weeks after the intake of probiotics. The clinical examination included probing pocket depth (PPD), bleeding on probing (BOP), the modified plaque index (mPI), and modified bleeding index (mBI). The number of bacteria was assessed using the PCR-invader method. The Wilcoxon rank-sum test and Wilcoxon signed-rank test with Bonferroni corrections were used for data analyses. Although the number of bacteria decreased after the administration of azithromycin in both groups, they increased again thereafter. No significant difference was observed in bacterial numbers between the two groups. Although PPD in the probiotics group was significantly lower at 4 and 24 weeks than at 0 weeks (pprobiotics group than in the placebo group (pprobiotics prevent inflammation by affecting host responses rather than improving microbial flora in peri-implant sulci in peri-implantitis patients. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  10. Invisalign and traditional orthodontic treatment postretention outcomes compared using the American Board of Orthodontics objective grading system.

    Science.gov (United States)

    Kuncio, Daniel; Maganzini, Anthony; Shelton, Clarence; Freeman, Katherine

    2007-09-01

    To compare the postretention dental changes between patients treated with Invisalign and those treated with conventional fixed appliances. This is a comparative cohort study using patient records of one orthodontist in New York City. Two groups of patients were identified that differed only in the method of treatment (Invisalign and Braces group). Dental casts and panoramic radiographs were collected and analyzed using the objective grading system (OGS) of the American Board of Orthodontics (ABO). The cases were evaluated immediately after appliance removal (T1) and at a postretention time (T2), three years after appliance removal. All patients had completed active orthodontic treatment and had undergone at least one year of retention. A Wilcoxon rank sum test was used to evaluate differences in treatment outcomes between the groups for each of the eight categories in the OGS, including four additional subcategories in the alignment category. A Wilcoxon signed rank test was used to determine the significance of changes within each group from T1 to T2. The change in the total alignment score in the Invisalign group was significantly larger than that for the Braces group. There were significant changes in total alignment and mandibular anterior alignment in both groups. There were significant changes in maxillary anterior alignment in the Invisalign group only. In this sample for this period of observation, patients treated with Invisalign relapsed more than those treated with conventional fixed appliances.

  11. An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students.

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Flores-Peña, Yolanda; De León-Leal, Silvia; Vázquez-Martínez, Carlos Alberto; Farías-Calderón, Ana Gabriela; Melo-Santiesteban, Guadalupe; Elizondo-Zapién, Rosa María; Hernandez-Hernandez, Dulce María; Garza-Moya, Rubén; Cerda-Flores, Ricardo Martín

    2015-01-01

    Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. An educational strategy for high school students in Mexico (2011-2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test-Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = - 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way.

  12. Static, Lightweight Includes Resolution for PHP

    NARCIS (Netherlands)

    M.A. Hills (Mark); P. Klint (Paul); J.J. Vinju (Jurgen)

    2014-01-01

    htmlabstractDynamic languages include a number of features that are challenging to model properly in static analysis tools. In PHP, one of these features is the include expression, where an arbitrary expression provides the path of the file to include at runtime. In this paper we present two

  13. Article Including Environmental Barrier Coating System

    Science.gov (United States)

    Lee, Kang N. (Inventor)

    2015-01-01

    An enhanced environmental barrier coating for a silicon containing substrate. The enhanced barrier coating may include a bond coat doped with at least one of an alkali metal oxide and an alkali earth metal oxide. The enhanced barrier coating may include a composite mullite bond coat including BSAS and another distinct second phase oxide applied over said surface.

  14. Rare thoracic cancers, including peritoneum mesothelioma

    NARCIS (Netherlands)

    Siesling, Sabine; van der Zwan, Jan Maarten; Izarzugaza, Isabel; Jaal, Jana; Treasure, Tom; Foschi, Roberto; Ricardi, Umberto; Groen, Harry; Tavilla, Andrea; Ardanaz, Eva

    Rare thoracic cancers include those of the trachea, thymus and mesothelioma (including peritoneum mesothelioma). The aim of this study was to describe the incidence, prevalence and survival of rare thoracic tumours using a large database, which includes cancer patients diagnosed from 1978 to 2002,

  15. Rare thoracic cancers, including peritoneum mesothelioma

    NARCIS (Netherlands)

    Siesling, Sabine; Zwan, J.M.V.D.; Izarzugaza, I.; Jaal, J.; Treasure, T.; Foschi, R.; Ricardi, U.; Groen, H.; Tavilla, A.; Ardanaz, E.

    2012-01-01

    Rare thoracic cancers include those of the trachea, thymus and mesothelioma (including peritoneum mesothelioma). The aim of this study was to describe the incidence, prevalence and survival of rare thoracic tumours using a large database, which includes cancer patients diagnosed from 1978 to 2002,

  16. Composite Pressure Vessel Including Crack Arresting Barrier

    Science.gov (United States)

    DeLay, Thomas K. (Inventor)

    2013-01-01

    A pressure vessel includes a ported fitting having an annular flange formed on an end thereof and a tank that envelopes the annular flange. A crack arresting barrier is bonded to and forming a lining of the tank within the outer surface thereof. The crack arresting barrier includes a cured resin having a post-curing ductility rating of at least approximately 60% through the cured resin, and further includes randomly-oriented fibers positioned in and throughout the cured resin.

  17. Including Organizational Cultural Parameters in Work Processes

    National Research Council Canada - National Science Library

    Handley, Holly A; Heacox, Nancy J

    2004-01-01

    .... In order to represent the organizational impact on the work process, five organizational cultural parameters were identified and included in an algorithm for modeling and simulation of cultural...

  18. Haemophilus influenzae Disease (Including Hib) Symptoms

    Science.gov (United States)

    ... Links Global Hib Vaccination Hib Vaccination Meningitis Pneumonia Sepsis ... Haemophilus influenzae , including H. influenzae type b or Hib, can cause many different kinds of infections . Symptoms depend on ...

  19. 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...

  20. Including Indigenous Minorities in Decision-Making

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    Based on theories of public sphere participation and deliberative democracy, this book presents empirical results from a study of experiences with including Aboriginal and Maori groups in political decision-making in respectively Western Australia and New Zealand...

  1. Lung Disease Including Asthma and Adult Vaccination

    Science.gov (United States)

    ... Diseases Resources Lung Disease including Asthma and Adult Vaccination Language: English (US) Español (Spanish) Recommend on Facebook ... more about health insurance options. Learn about adult vaccination and other health conditions Asplenia Diabetes Heart Disease, ...

  2. Births and deaths including fetal deaths

    Data.gov (United States)

    U.S. Department of Health & Human Services — Access to a variety of United States birth and death files including fetal deaths: Birth Files, 1968-2009; 1995-2005; Fetal death file, 1982-2005; Mortality files,...

  3. Isolators Including Main Spring Linear Guide Systems

    Science.gov (United States)

    Goold, Ryan (Inventor); Buchele, Paul (Inventor); Hindle, Timothy (Inventor); Ruebsamen, Dale Thomas (Inventor)

    2017-01-01

    Embodiments of isolators, such as three parameter isolators, including a main spring linear guide system are provided. In one embodiment, the isolator includes first and second opposing end portions, a main spring mechanically coupled between the first and second end portions, and a linear guide system extending from the first end portion, across the main spring, and toward the second end portion. The linear guide system expands and contracts in conjunction with deflection of the main spring along the working axis, while restricting displacement and rotation of the main spring along first and second axes orthogonal to the working axis.

  4. Electrochemical cell structure including an ionomeric barrier

    Science.gov (United States)

    Lambert, Timothy N.; Hibbs, Michael

    2017-06-20

    An apparatus includes an electrochemical half-cell comprising: an electrolyte, an anode; and an ionomeric barrier positioned between the electrolyte and the anode. The anode may comprise a multi-electron vanadium phosphorous alloy, such as VP.sub.x, wherein x is 1-5. The electrochemical half-cell is configured to oxidize the vanadium and phosphorous alloy to release electrons. A method of mitigating corrosion in an electrochemical cell includes disposing an ionomeric barrier in a path of electrolyte or ion flow to an anode and mitigating anion accumulation on the surface of the anode.

  5. Electric Power Monthly, August 1990. [Glossary included

    Energy Technology Data Exchange (ETDEWEB)

    1990-11-29

    The Electric Power Monthly (EPM) presents monthly summaries of electric utility statistics at the national, Census division, and State level. The purpose of this publication is to provide energy decisionmakers with accurate and timely information that may be used in forming various perspectives on electric issues that lie ahead. Data includes generation by energy source (coal, oil, gas, hydroelectric, and nuclear); generation by region; consumption of fossil fuels for power generation; sales of electric power, cost data; and unusual occurrences. A glossary is included.

  6. Diversification of Smallholder Tobacco Systems to include ...

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

    Tobacco is the mainstay of the economy of Malawi, accounting for over 70% of export earnings. Of the 100 000 members of the National Smallholder Farmers' Association of Malawi (NASFAM), 60% rely on tobacco for their sole source of income. Like their counterparts elsewhere, they face many difficulties, including: ...

  7. BIOLOGIC AND ECONOMIC EFFECTS OF INCLUDING DIFFERENT ...

    African Journals Online (AJOL)

    The biologic and economic effects of including three agro-industrial by-products as ingredients in turkey poult diets were investigated using 48 turkey poults in a completely randomised design experiment. Diets were formulated to contain the three by-products – wheat offal, rice husk and palm kernel meal, each at 20% level ...

  8. Extending flood damage assessment methodology to include ...

    African Journals Online (AJOL)

    Optimal and sustainable flood plain management, including flood control, can only be achieved when the impacts of flood control measures are considered for both the man-made and natural environments, and the sociological aspects are fully considered. Until now, methods/models developed to determine the influences ...

  9. Including Children Dependent on Ventilators in School.

    Science.gov (United States)

    Levine, Jack M.

    1996-01-01

    Guidelines for including ventilator-dependent children in school are offered, based on experience with six such students at a New York State school. Guidelines stress adherence to the medical management plan, the school-family partnership, roles of the social worker and psychologist, orientation, transportation, classroom issues, and steps toward…

  10. Musculoskeletal ultrasound including definitions for ultrasonographic pathology

    DEFF Research Database (Denmark)

    Wakefield, RJ; Balint, PV; Szkudlarek, Marcin

    2005-01-01

    Ultrasound (US) has great potential as an outcome in rheumatoid arthritis trials for detecting bone erosions, synovitis, tendon disease, and enthesopathy. It has a number of distinct advantages over magnetic resonance imaging, including good patient tolerability and ability to scan multiple joint...

  11. Modernizing Agrifood Markets : Including Small Producers in ...

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

    Against this baseline data, they will endeavor to identify success stories or examples of interventions that ensure small farmers' access to modernizing agrifood markets. The research will inform a set of policy recommendations to be promoted through policy platforms in a large number of developing countries, including but ...

  12. Including Students with Visual Impairments: Softball

    Science.gov (United States)

    Brian, Ali; Haegele, Justin A.

    2014-01-01

    Research has shown that while students with visual impairments are likely to be included in general physical education programs, they may not be as active as their typically developing peers. This article provides ideas for equipment modifications and game-like progressions for one popular physical education unit, softball. The purpose of these…

  13. Numerical simulation of spark ignition including ionization

    NARCIS (Netherlands)

    Thiele, M; Selle, S; Riedel, U; Warnatz, J; Maas, U

    2000-01-01

    A detailed understanding of the processes associated Midi spark ignition, as a first step during combustion, is of great importance fur clean operation of spark ignition engines. In the past 10 years. a growing concern for environmental protection, including low emission of pollutants, has increased

  14. Perinatal Outcomes in Cephalic Compared With Noncephalic Singleton Presentation in the Setting of Preterm Premature Rupture of Membranes Before 32 Weeks of Gestation.

    Science.gov (United States)

    Yee, Lynn M; Grobman, William A

    2016-10-01

    To investigate the relationship between fetal presentation at the time of admission for preterm premature rupture of membranes (PROM) and perinatal outcomes, including gestational latency, among women in a large and well-characterized population with preterm PROM at less than 32 weeks of gestation. This was a secondary analysis of data from women randomized to receive magnesium sulfate compared with placebo in the previously reported Maternal-Fetal Medicine Units Network Beneficial Effects of Antenatal Magnesium Sulfate (1997-2004) trial. Women with a singleton gestation and preterm PROM were included. Fetal presentation at the time of randomization was recorded. Associations of fetal position (cephalic compared with noncephalic) with perinatal outcomes were compared using χ, Fisher exact, and Wilcoxon rank-sum tests. Perinatal outcomes included gestational latency, abruption, and neonatal morbidity and mortality. Multivariable regression (logistic, linear, and Cox) analyses were used to adjust for potential confounding factors. Of the 1,767 eligible women, 439 (24.5%) had a noncephalic presentation. Noncephalic presentation was associated with an earlier median gestational age at the time of preterm PROM (26.6 compared with 28.4 weeks of gestation, Ppreterm PROM are at greater risk of neonatal death.

  15. Factors associated with poor healing and recurrence of venous ulceration.

    Science.gov (United States)

    Labropoulos, Nicos; Wang, Eric D; Lanier, Steven T; Khan, Sami U

    2012-01-01

    Plastic surgeons are often approached for wound management and closure of chronic venous ulcers that fail to heal despite multimodal management. The authors present a retrospective analysis of a large series of venous ulcers to determine factors predicting nonhealing and recurrence. Consecutive patients with chronic venous ulcers (≥ 2-cm diameter) were examined for the presence of superficial, perforating, or deep venous disease, including reflux and/or obstruction. Treatment included compression, venous ligation, stripping, thermal ablation, sclerotherapy, and local wound care. Ulcers refractory to 6 months of treatment were defined as nonhealing ulcers. Data were analyzed for differences in baseline patient and ulcer characteristics and clinical course of nonhealing ulcers. Data were compared using Wilcoxon rank sum, chi-square, and Fisher's exact tests using Sigma Stat and SPSS, with α set at p ulcers in 127 patients. Factors associated with ulcer nonhealing included advanced age, increased body mass index, history of deep venous thrombosis, noncompliance with compression therapy, and large ulcer area. One hundred thirty-one of the ulcers (85.6 percent) healed within 6 months and 147 (96 percent) of the ulcers ultimately healed without the need for operative plastic surgical intervention. A thorough understanding of risks and expected clinical course is required for assessment of the nonhealing venous ulcer. The authors recommend identification and correction of underlying venous abnormality and a minimum of at least 6 months of compression and local wound care followed by reassessment of venous function before operative plastic surgical intervention should be considered. Risk, III.

  16. SOCR Analyses: Implementation and Demonstration of a New Graphical Statistics Educational Toolkit

    Directory of Open Access Journals (Sweden)

    Annie Chu

    2009-04-01

    Full Text Available The web-based, Java-written SOCR (Statistical Online Computational Resource toolshave been utilized in many undergraduate and graduate level statistics courses for sevenyears now (Dinov 2006; Dinov et al. 2008b. It has been proven that these resourcescan successfully improve students' learning (Dinov et al. 2008b. Being rst publishedonline in 2005, SOCR Analyses is a somewhat new component and it concentrate on datamodeling for both parametric and non-parametric data analyses with graphical modeldiagnostics. One of the main purposes of SOCR Analyses is to facilitate statistical learn-ing for high school and undergraduate students. As we have already implemented SOCRDistributions and Experiments, SOCR Analyses and Charts fulll the rest of a standardstatistics curricula. Currently, there are four core components of SOCR Analyses. Linearmodels included in SOCR Analyses are simple linear regression, multiple linear regression,one-way and two-way ANOVA. Tests for sample comparisons include t-test in the para-metric category. Some examples of SOCR Analyses' in the non-parametric category areWilcoxon rank sum test, Kruskal-Wallis test, Friedman's test, Kolmogorov-Smirno testand Fligner-Killeen test. Hypothesis testing models include contingency table, Friedman'stest and Fisher's exact test. The last component of Analyses is a utility for computingsample sizes for normal distribution. In this article, we present the design framework,computational implementation and the utilization of SOCR Analyses.

  17. Photoactive devices including porphyrinoids with coordinating additives

    Science.gov (United States)

    Forrest, Stephen R; Zimmerman, Jeramy; Yu, Eric K; Thompson, Mark E; Trinh, Cong; Whited, Matthew; Diev, Vlacheslav

    2015-05-12

    Coordinating additives are included in porphyrinoid-based materials to promote intermolecular organization and improve one or more photoelectric characteristics of the materials. The coordinating additives are selected from fullerene compounds and organic compounds having free electron pairs. Combinations of different coordinating additives can be used to tailor the characteristic properties of such porphyrinoid-based materials, including porphyrin oligomers. Bidentate ligands are one type of coordinating additive that can form coordination bonds with a central metal ion of two different porphyrinoid compounds to promote porphyrinoid alignment and/or pi-stacking. The coordinating additives can shift the absorption spectrum of a photoactive material toward higher wavelengths, increase the external quantum efficiency of the material, or both.

  18. Electric power monthly, September 1990. [Glossary included

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-17

    The purpose of this report is to provide energy decision makers with accurate and timely information that may be used in forming various perspectives on electric issues. The power plants considered include coal, petroleum, natural gas, hydroelectric, and nuclear power plants. Data are presented for power generation, fuel consumption, fuel receipts and cost, sales of electricity, and unusual occurrences at power plants. Data are compared at the national, Census division, and state levels. 4 figs., 52 tabs. (CK)

  19. Power generation method including membrane separation

    Science.gov (United States)

    Lokhandwala, Kaaeid A.

    2000-01-01

    A method for generating electric power, such as at, or close to, natural gas fields. The method includes conditioning natural gas containing C.sub.3+ hydrocarbons and/or acid gas by means of a membrane separation step. This step creates a leaner, sweeter, drier gas, which is then used as combustion fuel to run a turbine, which is in turn used for power generation.

  20. Should Trade Agreements Include Environmental Policy?

    OpenAIRE

    Josh Ederington

    2010-01-01

    This article examines the extent to which environmental and trade policies should be treated equally, or symmetrically, in international negotiations. It reviews the recent economics literature on trade and the environment to address two questions. First, should trade negotiations include negotiations over environmental policies and the setting of binding environmental standards? Second, if there are grounds for international environmental negotiations, should environmental agreements b...

  1. Jet-calculus approach including coherence effects

    International Nuclear Information System (INIS)

    Jones, L.M.; Migneron, R.; Narayanan, K.S.S.

    1987-01-01

    We show how integrodifferential equations typical of jet calculus can be combined with an averaging procedure to obtain jet-calculus-based results including the Mueller interference graphs. Results in longitudinal-momentum fraction x for physical quantities are higher at intermediate x and lower at large x than with the conventional ''incoherent'' jet calculus. These results resemble those of Marchesini and Webber, who used a Monte Carlo approach based on the same dynamics

  2. Revisiting Hansen Solubility Parameters by Including Thermodynamics.

    Science.gov (United States)

    Louwerse, Manuel J; Maldonado, Ana; Rousseau, Simon; Moreau-Masselon, Chloe; Roux, Bernard; Rothenberg, Gadi

    2017-11-03

    The Hansen solubility parameter approach is revisited by implementing the thermodynamics of dissolution and mixing. Hansen's pragmatic approach has earned its spurs in predicting solvents for polymer solutions, but for molecular solutes improvements are needed. By going into the details of entropy and enthalpy, several corrections are suggested that make the methodology thermodynamically sound without losing its ease of use. The most important corrections include accounting for the solvent molecules' size, the destruction of the solid's crystal structure, and the specificity of hydrogen-bonding interactions, as well as opportunities to predict the solubility at extrapolated temperatures. Testing the original and the improved methods on a large industrial dataset including solvent blends, fit qualities improved from 0.89 to 0.97 and the percentage of correct predictions rose from 54 % to 78 %. Full Matlab scripts are included in the Supporting Information, allowing readers to implement these improvements on their own datasets. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Drug delivery device including electrolytic pump

    KAUST Repository

    Foulds, Ian G.

    2016-03-31

    Systems and methods are provided for a drug delivery device and use of the device for drug delivery. In various aspects, the drug delivery device combines a “solid drug in reservoir” (SDR) system with an electrolytic pump. In various aspects an improved electrolytic pump is provided including, in particular, an improved electrolytic pump for use with a drug delivery device, for example an implantable drug delivery device. A catalytic reformer can be incorporated in a periodically pulsed electrolytic pump to provide stable pumping performance and reduced actuation cycle.

  4. Aerosol simulation including chemical and nuclear reactions

    International Nuclear Information System (INIS)

    Marwil, E.S.; Lemmon, E.C.

    1985-01-01

    The numerical simulation of aerosol transport, including the effects of chemical and nuclear reactions presents a challenging dynamic accounting problem. Particles of different sizes agglomerate and settle out due to various mechanisms, such as diffusion, diffusiophoresis, thermophoresis, gravitational settling, turbulent acceleration, and centrifugal acceleration. Particles also change size, due to the condensation and evaporation of materials on the particle. Heterogeneous chemical reactions occur at the interface between a particle and the suspending medium, or a surface and the gas in the aerosol. Homogeneous chemical reactions occur within the aersol suspending medium, within a particle, and on a surface. These reactions may include a phase change. Nuclear reactions occur in all locations. These spontaneous transmutations from one element form to another occur at greatly varying rates and may result in phase or chemical changes which complicate the accounting process. This paper presents an approach for inclusion of these effects on the transport of aerosols. The accounting system is very complex and results in a large set of stiff ordinary differential equations (ODEs). The techniques for numerical solution of these ODEs require special attention to achieve their solution in an efficient and affordable manner. 4 refs

  5. Antiretroviral Resistance and Pregnancy Characteristics of Women with Perinatal and Nonperinatal HIV Infection

    Directory of Open Access Journals (Sweden)

    Gweneth B. Lazenby

    2016-01-01

    Full Text Available Objective. To compare HIV drug resistance in pregnant women with perinatal HIV (PHIV and those with nonperinatal HIV (NPHIV infection. Methods. We conducted a multisite cohort study of PHIV and NPHIV women from 2000 to 2014. Sample size was calculated to identify a fourfold increase in antiretroviral (ARV drug resistance in PHIV women. Continuous variables were compared using Student’s t-test and Wilcoxon rank-sum tests. Categorical variables were compared using χ2 and Fisher’s exact tests. Univariate analysis was used to determine factors associated with antiretroviral drug resistance. Results. Forty-one PHIV and 41 NPHIV participants were included. Women with PHIV were more likely to have drug resistance than those with NPHIV ((55% versus 17%, p=0.03, OR 6.0 (95% CI 1.0–34.8, p=0.05, including multiclass resistance (15% versus 0, p=0.03, and they were more likely to receive nonstandard ARVs during pregnancy (27% versus 5%, p=0.01. PHIV and NPHIV women had similar rates of preterm birth (11% versus 28%, p=0.08 and cesarean delivery (47% versus 46%, p=0.9. Two infants born to a single NPHIV woman acquired HIV infection. Conclusions. PHIV women have a high frequency of HIV drug resistance mutations, leading to nonstandard ARVs use during pregnancy. Despite nonstandard ARV use during pregnancy, PHIV women did not experience increased rates of adverse pregnancy outcomes.

  6. Predictors of Immunosuppressive Regulatory T Lymphocytes in Healthy Women

    International Nuclear Information System (INIS)

    Hampras, S. S.; Nesline, M.; Davis, W.; Moysich, K. B.; Wallace, P. K.; Odunsi, K.; Furlani, N.

    2012-01-01

    Immunosuppressive regulatory T (Treg) cells play an important role in antitumor immunity, self-tolerance, transplantation tolerance, and attenuation of allergic response. Higher proportion of Treg cells has been observed in peripheral blood of cancer cases compared to controls. Little is known about potential epidemiological predictors of Treg cell levels in healthy individuals. We conducted a cross-sectional study including 75 healthy women, between 20 and 80 years of age, who participated in the Data Bank and Bio Repository (DBBR) program at Roswell Park Cancer Institute (RPCI), Buffalo, NY, USA. Peripheral blood levels of CD4 + CD25 + FOXP3 + Treg cells were measured using flow cytometric analysis. A range of risk factors was evaluated using Wilcoxon Rank-Sum test, Kruskal-Wallis test, and linear regression. Age, smoking, medications for treatment of osteoporosis, postmenopausal status, body mass index (BMI), and hormone replacement therapy (HRT) were found to be significant positive predictors of Treg cell levels in peripheral blood (π≤0.05 ). Higher education, exercise, age at first birth, oral contraceptives, and use of Ibuprofen were found be significant (π<0.05) negative predictors of Treg levels. Thus, various epidemiological risk factors might explain interindividual variation in immune response to pathological conditions, including cancer.

  7. Phyllodes Tumor of the Breast: Ultrasound-Pathology Correlation.

    Science.gov (United States)

    Kalambo, Megan; Adrada, Beatriz E; Adeyefa, Modupe M; Krishnamurthy, Savitri; Hess, Ken; Carkaci, Selin; Whitman, Gary J

    2018-02-07

    The purpose of this study is to evaluate the sonographic and histopathologic features distinguishing benign from borderline and malignant phyllodes tumors. The ultrasound examinations of women with pathologically proven phyllodes tumors from 2004 to 2011 were retrospectively reviewed. The sonographic features of benign, borderline, and malignant phyllodes tumors were compared and analyzed using the American College of Radiology's BI-RADS ultrasound lexicon. Fisher exact test and Wilcoxon rank sum test were used for statistical analysis. Fifty-nine women were included in the study; 28 benign (47%), 19 malignant (32%), and 12 borderline (20%) phyllodes tumors were identified. Significant univariate predictors of increased risk of borderline or malignant phyllodes tumors were patient age greater than 55 years (p = 0.014), irregular lesion shape (p = 0.011), and longest lesion dimension greater than 7 cm (p = 0.0022) at sonography. No significant differences were observed in lesion margins, boundaries, echo patterns, or posterior acoustic features. There is substantial overlap in the sonographic features of benign and borderline or malignant phyllodes tumors. Understanding the clinical and sonographic features of phyllodes tumors may aid the radiologist in predicting biological behavior, including the likelihood of benign versus borderline or malignant phyllodes tumors at pathologic analysis.

  8. A randomized trial of social media from Circulation.

    Science.gov (United States)

    Fox, Caroline S; Bonaca, Marc A; Ryan, John J; Massaro, Joseph M; Barry, Karen; Loscalzo, Joseph

    2015-01-06

    Medical journals use social media to distribute the findings of published articles. Whether social media exposure to original articles improves article impact metrics is uncertain. Articles were randomized to receive targeted social media exposure from Circulation, including postings on the journal's Facebook and Twitter feeds. The primary end point was 30-day article page views. We conducted an intention-to-treat analysis comparing article page views by the Wilcoxon Rank sum test between articles randomized to social media as compared with those in the control group, which received no social media from Circulation. Prespecified subgroups included article type (population/clinical/basic), US versus non-US corresponding author, and whether the article received an editorial. Overall, 243 articles were randomized: 121 in the social media arm and 122 in the control arm. There was no difference in median 30-day page views (409 [social media] versus 392 [control], P=0.80). No differences were observed by article type (clinical, population, or basic science; P=0.19), whether an article had an editorial (P=0.87), or whether the corresponding author was from the United States (P=0.73). A social media strategy for a cardiovascular journal did not increase the number of times an article was viewed. Further research is necessary to understand and quantify the ways in which social media can increase the impact of published cardiovascular research. © 2014 American Heart Association, Inc.

  9. Impact of laparoscopic Roux-en-Y Gastric bypass versus sleeve gastrectomy on postoperative lipid values.

    Science.gov (United States)

    Van Osdol, Andrew D; Grover, Brandon T; Borgert, Andrew J; Kallies, Kara J; Kothari, Shanu N

    2017-03-01

    Metabolic surgery has been shown to significantly improve many obesity-related co-morbidities, including dyslipidemia. The literature has produced mixed results comparing postoperative lipid values after laparoscopic Roux-en-Y gastric bypass (LRYGB) compared to laparoscopic sleeve gastrectomy (LSG); with some indicating significantly greater reductions in total cholesterol and low-density lipoprotein (LDL) in LRYGB versus LSG, and others reporting no significant differences. To evaluate the postoperative lipid values after LRYGB versus LSG at a community hospital. Integrated multispecialty health system with a community teaching hospital. A retrospective review of our prospective database was completed to identify patients who underwent either LRYGB or LSG at our institution from 2001 through 2013. Lipid values available at 6-18 months postoperative were evaluated. Statistical analysis included χ 2 and Wilcoxon rank-sum tests. A P value130 mg/dL (P = .68), respectively. HDL values were within the recommended range in 52% and 57% of LRYGB and LSG patients, respectively (P = .64). Patients who underwent LRYGB had a greater postoperative reduction in total cholesterol, LDL, and triglycerides. LRYGB may be the more appropriate bariatric procedure for patients with significant preoperative hypercholesterolemia. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  10. Perioperative blood transfusion in gynecologic oncology surgery: analysis of the National Surgical Quality Improvement Program Database.

    Science.gov (United States)

    Prescott, Lauren S; Aloia, Thomas A; Brown, Alaina J; Taylor, Jolyn S; Munsell, Mark F; Sun, Charlotte C; Schmeler, Kathleen M; Levenback, Charles F; Bodurka, Diane C

    2015-01-01

    To use a large-scale multi-institutional dataset to quantify the prevalence of packed red blood cell transfusions and examine the associations between transfusion and perioperative outcomes in gynecologic cancer surgery. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) participant use file was queried for all gynecologic cancer cases between 2010 and 2012. Demographic, preoperative and intraoperative variables were compared between transfusion and non-transfusion groups using chi-squared, Fisher's exact and Wilcoxon rank-sum tests. The primary endpoint was 30-day composite morbidity. Secondary endpoints included composite surgical site infections, mortality and length of stay. A total of 8519 patients were analyzed, and 13.8% received a packed red blood cell transfusion. In the multivariate analysis, after adjusting for key clinical and perioperative factors, including preoperative anemia and case magnitude, transfusion was associated with higher composite morbidity (OR = 1.85, 95% CI 1.5-2.24), surgical site infections (OR 1.80, 95% CI 1.39-2.35), mortality (OR 3.38, 95% CI 1.80-6.36) and length of hospital stay (3.02 days v. 7.17 days, P gynecologic cancer should be scrutinized. Examination of institutional practices and creation of transfusion guidelines for gynecologic malignancies could potentially result in better utilization of blood bank resources and clinical outcomes among patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Teaching procedural skills to medical students: A pilot procedural skills lab.

    Science.gov (United States)

    Katz, Laurence M; Finch, Alexander; McKinnish, Tyler; Gilliland, Kurt; Tolleson-Rinehart, Sue; Marks, Bonita L

    2017-01-01

    Medical students have limited confidence in performing procedural skills. A pilot study was conducted to evaluate the effect of a multifaceted Procedural Skills Lab (PSL) on the confidence of medical students to perform procedural skills. Twelve 2nd year medical students were randomly selected to participate in a pilot PSL. The PSL students met with an instructor for 2 h once a week for 4 weeks. Students participated in a flipped classroom and spaced education program before laboratory sessions that included a cadaver laboratory. Procedural skills included a focused assessment with sonography in trauma (FAST) scan, cardiac echocardiogram, lumbar puncture, arthrocentesis, and insertion of intraosseous and intravenous catheters. Students in the PSL were asked to rank their confidence in performing procedural skills before and after completion of the laboratory sessions (Wilcoxon ranked-sum test). A web-based questionnaire was also emailed to all 2nd year medical students to establish a baseline frequency for observing, performing, and confidence performing procedural skills (Mann-Whitney U-test). Fifty-nine percent (n = 106) of 180 2nd year medical students (n = 12 PSL students [treatment group], n = 94 [control group]) completed the survey. Frequency of observation, performance, and confidence in performing procedural skills was similar between the control and treatment groups at baseline. There was an increased confidence level (p skills for the treatment group after completion of the PSL. An innovative PSL may increase students' confidence to perform procedural skills. Future studies will examine competency after a PSL.

  12. Including gauge corrections to thermal leptogenesis

    International Nuclear Information System (INIS)

    Huetig, Janine

    2013-01-01

    This thesis provides the first approach of a systematic inclusion of gauge corrections to leading order to the ansatz of thermal leptogenesis. We have derived a complete expression for the integrated lepton number matrix including all resummations needed. For this purpose, a new class of diagram has been invented, namely the cylindrical diagram, which allows diverse investigations into the topic of leptogenesis such as the case of resonant leptogenesis. After a brief introduction of the topic of the baryon asymmetry in the universe and a discussion of its most promising solutions as well as their advantages and disadvantages, we have presented our framework of thermal leptogenesis. An effective model was described as well as the associated Feynman rules. The basis for using nonequilibrium quantum field theory has been built in chapter 3. At first, the main definitions have been presented for equilibrium thermal field theory, afterwards we have discussed the Kadanoff-Baym equations for systems out of equilibrium using the example of the Majorana neutrino. The equations have also been solved in the context of leptogenesis in chapter 4. Since gauge corrections play a crucial role throughout this thesis, we have also repeated the naive ansatz by replacing the free equilibrium propagator by propagators including thermal damping rates due to the Standard Model damping widths for lepton and Higgs fields. It is shown that this leads to a comparable result to the solutions of the Boltzmann equations for thermal leptogenesis. Thus it becomes obvious that Standard Model corrections are not negligible for thermal leptogenesis and therefore need to be included systematically from first principles. In order to achieve this we have started discussing the calculation of ladder rung diagrams for Majorana neutrinos using the HTL and the CTL approach in chapter 5. All gauge corrections are included in this framework and thus it has become the basis for the following considerations

  13. Grand unified models including extra Z bosons

    International Nuclear Information System (INIS)

    Li Tiezhong

    1989-01-01

    The grand unified theories (GUT) of the simple Lie groups including extra Z bosons are discussed. Under authors's hypothesis there are only SU 5+m SO 6+4n and E 6 groups. The general discussion of SU 5+m is given, then the SU 6 and SU 7 are considered. In SU 6 the 15+6 * +6 * fermion representations are used, which are not same as others in fermion content, Yukawa coupling and broken scales. A conception of clans of particles, which are not families, is suggested. These clans consist of extra Z bosons and the corresponding fermions of the scale. The all of fermions in the clans are down quarks except for the standard model which consists of Z bosons and 15 fermions, therefore, the spectrum of the hadrons which are composed of these down quarks are different from hadrons at present

  14. CLIC expands to include the Southern Hemisphere

    CERN Multimedia

    Roberto Cantoni

    2010-01-01

    Australia has recently joined the CLIC collaboration: the enlargement will bring new expertise and resources to the project, and is especially welcome in the wake of CERN budget redistributions following the recent adoption of the Medium Term Plan.   The countries involved in CLIC collaboration With the signing of a Memorandum of Understanding on 26 August 2010, the ACAS network (Australian Collaboration for Accelerator Science) became the 40th member of in the multilateral CLIC collaboration making Australia the 22nd country to join the collaboration. “The new MoU was signed by the ACAS network, which includes the Australian Synchrotron and the University of Melbourne”, explains Jean-Pierre Delahaye, CLIC Study Leader. “Thanks to their expertise, the Australian institutes will contribute greatly to the CLIC damping rings and the two-beam test modules." Institutes from any country wishing to join the CLIC collaboration are invited to assume responsibility o...

  15. Musculoskeletal ultrasound including definitions for ultrasonographic pathology

    DEFF Research Database (Denmark)

    Wakefield, RJ; Balint, PV; Szkudlarek, Marcin

    2005-01-01

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

  16. Education Program on Fossil Resources Including Coal

    Science.gov (United States)

    Usami, Masahiro

    Fossil fuels including coal play a key role as crucial energies in contributing to economic development in Asia. On the other hand, its limited quantity and the environmental problems causing from its usage have become a serious global issue and a countermeasure to solve such problems is very much demanded. Along with the pursuit of sustainable development, environmentally-friendly use of highly efficient fossil resources should be therefore, accompanied. Kyushu-university‧s sophisticated research through long years of accumulated experience on the fossil resources and environmental sectors together with the advanced large-scale commercial and empirical equipments will enable us to foster cooperative research and provide internship program for the future researchers. Then, this program is executed as a consignment business from the Ministry of Economy, Trade and Industry from 2007 fiscal year to 2009 fiscal year. The lecture that uses the textbooks developed by this program is scheduled to be started a course in fiscal year 2010.

  17. Should Broca's area include Brodmann area 47?

    Science.gov (United States)

    Ardila, Alfredo; Bernal, Byron; Rosselli, Monica

    2017-02-01

    Understanding brain organization of speech production has been a principal goal of neuroscience. Historically, brain speech production has been associated with so-called Broca’s area (Brodmann area –BA- 44 and 45), however, modern neuroimaging developments suggest speech production is associated with networks rather than with areas. The purpose of this paper was to analyze the connectivity of BA47 ( pars orbitalis) in relation to language . A meta-analysis was conducted to assess the language network in which BA47 is involved. The Brainmap database was used. Twenty papers corresponding to 29 experimental conditions with a total of 373 subjects were included. Our results suggest that BA47 participates in a “frontal language production system” (or extended Broca’s system). The BA47  connectivity found is also concordant with a minor role in language semantics. BA47 plays a central role in the language production system.

  18. Pulmonary disorders, including vocal cord dysfunction.

    Science.gov (United States)

    Greenberger, Paul A; Grammer, Leslie C

    2010-02-01

    The lung is a very complex immunologic organ and responds in a variety of ways to inhaled antigens, organic or inorganic materials, infectious or saprophytic agents, fumes, and irritants. There might be airways obstruction, restriction, neither, or both accompanied by inflammatory destruction of the pulmonary interstitium, alveoli, or bronchioles. This review focuses on diseases organized by their predominant immunologic responses, either innate or acquired. Pulmonary innate immune conditions include transfusion-related acute lung injury, World Trade Center cough, and acute respiratory distress syndrome. Adaptive immunity responses involve the systemic and mucosal immune systems, activated lymphocytes, cytokines, and antibodies that produce CD4(+) T(H)1 phenotypes, such as for tuberculosis or acute forms of hypersensitivity pneumonitis, and CD4(+) T(H)2 phenotypes, such as for asthma, Churg-Strauss syndrome, and allergic bronchopulmonary aspergillosis. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  19. CERN Technical Training: LABVIEW courses include RADE

    CERN Multimedia

    HR Department

    2009-01-01

    The contents of the "LabView Basic I" and "LabView Intermediate II" courses have recently been changed to include, respectively, an introduction to and expert training in the Rapid Application Development Environment (RADE). RADE is a LabView-based application developed at CERN to integrate LabView in the accelerator and experiment control infrastructure. It is a suitable solution to developing expert tools, machine development analysis and independent test facilities. The course names have also been changed to "LabVIEW Basics I with RADE Introduction" and "LabVIEW Intermediate II with Advanced RADE Application". " LabVIEW Basics I with RADE Introduction" is designed for: Users preparing to develop applications using LabVIEW, or NI Developer Suite; users and technical managers evaluating LabVIEW or NI Developer Suite in purchasing decisions; users pursuing the Certified LabVIEW Developer certification. The course pr...

  20. CERN Technical Training: LABVIEW courses include RADE

    CERN Multimedia

    HR Department

    2009-01-01

    The contents of "LabView Basic I" and "LabView Intermediate II" trainings have been recently changed to include, respectively, an introduction and an expert training on the Rapid Application Development Environment (RADE). RADE is a LabView-based application developed at CERN to integrate LabView in the accelerator and experiment control infrastructure. It is a suitable solution to develop expert tools, machine development analysis and independent test facilities. The course names have also been changed to "LabVIEW Basics I with RADE Introduction" and "LabVIEW Intermediate II with Advanced RADE Application". " LabVIEW Basics I with RADE Introduction" is designed for: Users preparing to develop applications using LabVIEW, or NI Developer Suite; users and technical managers evaluating LabVIEW or NI Developer Suite in purchasing decisions; users pursuing the Certified LabVIEW Developer certification. The course prepare...

  1. CERN Technical Training: LABVIEW courses include RADE

    CERN Multimedia

    HR Department

    2009-01-01

    The contents of the "LabView Basic I" and "LabView Intermediate II" courses have recently been changed to include, respectively, an introduction to and expert training in the Rapid Application Development Environment (RADE). RADE is a LabView-based application developed at CERN to integrate LabView in the accelerator and experiment control infrastructure. It is a suitable solution to developing expert tools, machine development analysis and independent test facilities. The course names have also been changed to "LabVIEW Basics I with RADE Introduction" and "LabVIEW Intermediate II with Advanced RADE Application". " LabVIEW Basics I with RADE Introduction" is designed for: Users preparing to develop applications using LabVIEW, or NI Developer Suite; users and technical managers evaluating LabVIEW or NI Developer Suite in purchasing decisions; users pursuing the Certified LabVIEW Developer certification. The course prepares participants to develop test and measurement, da...

  2. AMS at the ANU including biomedical applications

    International Nuclear Information System (INIS)

    Fifield, L.K.; Allan, G.L.; Cresswell, R.G.; Ophel, T.R.; King, S.J.; Day, J.P.

    1993-01-01

    An extensive accelerator mass spectrometry program has been conducted on the 14UD accelerator at the Australian National University since 1986. In the two years since the previous conference, the research program has expanded significantly to include biomedical applications of 26 Al and studies of landform evolution using isotopes produced in situ in surface rocks by cosmic ray bombardment. The system is now used for the measurement of 10 Be, 14 C, 26 Al, 36 Cl, 59 Ni and 129 I, and research is being undertaken in hydrology, environmental geochemistry, archaeology and biomedicine. On the technical side, a new test system has permitted the successful off-line development of a high-intensity ion source. A new injection line to the 14UD has been established and the new source is now in position and providing beams to the accelerator. 4 refs

  3. AMS at the ANU including biomedical applications

    Energy Technology Data Exchange (ETDEWEB)

    Fifield, L.K.; Allan, G.L.; Cresswell, R.G.; Ophel, T.R. [Australian National Univ., Canberra, ACT (Australia); King, S.J.; Day, J.P. [Manchester Univ. (United Kingdom). Dept. of Chemistry

    1993-12-31

    An extensive accelerator mass spectrometry program has been conducted on the 14UD accelerator at the Australian National University since 1986. In the two years since the previous conference, the research program has expanded significantly to include biomedical applications of {sup 26}Al and studies of landform evolution using isotopes produced in situ in surface rocks by cosmic ray bombardment. The system is now used for the measurement of {sup 10}Be, {sup 14}C, {sup 26}Al, {sup 36}Cl, {sup 59}Ni and {sup 129}I, and research is being undertaken in hydrology, environmental geochemistry, archaeology and biomedicine. On the technical side, a new test system has permitted the successful off-line development of a high-intensity ion source. A new injection line to the 14UD has been established and the new source is now in position and providing beams to the accelerator. 4 refs.

  4. A micromanipulation cell including a tool changer

    Science.gov (United States)

    Clévy, Cédric; Hubert, Arnaud; Agnus, Joël; Chaillet, Nicolas

    2005-10-01

    This paper deals with the design, fabrication and characterization of a tool changer for micromanipulation cells. This tool changer is part of a manipulation cell including a three linear axes robot and a piezoelectric microgripper. All these parts are designed to perform micromanipulation tasks in confined spaces such as a microfactory or in the chamber of a scanning electron microscope (SEM). The tool changer principle is to fix a pair of tools (i.e. the gripper tips) either on the tips of the microgripper actuator (piezoceramic bulk) or on a tool magazine. The temperature control of a thermal glue enables one to fix or release this pair of tools. Liquefaction and solidification are generated by surface mounted device (SMD) resistances fixed on the surface of the actuator or magazine. Based on this principle, the tool changer can be adapted to other kinds of micromanipulation cells. Hundreds of automatic tool exchanges were performed with a maximum positioning error between two consecutive tool exchanges of 3.2 µm, 2.3 µm and 2.8 µm on the X, Y and Z axes respectively (Z refers to the vertical axis). Finally, temperature measurements achieved under atmospheric pressure and in a vacuum environment and pressure measurements confirm the possibility of using this device in the air as well as in a SEM.

  5. Robust Unit Commitment Including Frequency Stability Constraints

    Directory of Open Access Journals (Sweden)

    Felipe Pérez-Illanes

    2016-11-01

    Full Text Available An increased use of variable generation technologies such as wind power and photovoltaic generation can have important effects on system frequency performance during normal operation as well as contingencies. The main reasons are the operational principles and inherent characteristics of these power plants like operation at maximum power point and no inertial response during power system imbalances. This has led to new challenges for Transmission System Operators in terms of ensuring system security during contingencies. In this context, this paper proposes a Robust Unit Commitment including a set of additional frequency stability constraints. To do this, a simplified dynamic model of the initial system frequency response is used in combination with historical frequency nadir data during contingencies. The proposed approach is especially suitable for power systems with cost-based economic dispatch like those in most Latin American countries. The study is done considering the Northern Interconnected System of Chile, a 50-Hz medium size isolated power system. The results obtained were validated by means of dynamic simulations of different system contingencies.

  6. Unifying all elementary particle forces including gravity

    International Nuclear Information System (INIS)

    Terazawa, H.

    1979-01-01

    It is a final goal in physics to unify all four basic forces, strong, weak, electromagnetic and gravitational. First, the unified gauge theories of strong, weak and electromagnetic interactions are discussed. There are two standard models, the model of Pati and Salam in which leptons have the fourth color, and the model of Georgi and Glashow in which a simple group SU (5) is assumed for grand unification. Two mass relations for leptons and quarks were derived, and the extension of the Georgi-Glashow model to a grand unified model of SU (6) gauge group has been made. The quantization of the electric charge of elementary particles is one of the most satisfactory features in grand unified gauge theories. The constraint relations between the gauge couplings, the weak mixing angle and the mass scale of symmetry breaking owing to the renormalization effect are not so severe as those in the grand unified models. However, the mass scale becomes far above the Planck mass in some cases. The baryon number non-conservation is one of the most intriguing features common to grand unified gauge theories. The unified models of all elementary particle forces including gravity are discussed. The discovery of weak vector bosons and the production of subquark pairs are anticipated. (Kako, I.)

  7. SEEPAGE MODEL FOR PA INCLUDING DRIFT COLLAPSE

    International Nuclear Information System (INIS)

    C. Tsang

    2004-01-01

    The purpose of this report is to document the predictions and analyses performed using the seepage model for performance assessment (SMPA) for both the Topopah Spring middle nonlithophysal (Tptpmn) and lower lithophysal (Tptpll) lithostratigraphic units at Yucca Mountain, Nevada. Look-up tables of seepage flow rates into a drift (and their uncertainty) are generated by performing numerical simulations with the seepage model for many combinations of the three most important seepage-relevant parameters: the fracture permeability, the capillary-strength parameter 1/a, and the percolation flux. The percolation flux values chosen take into account flow focusing effects, which are evaluated based on a flow-focusing model. Moreover, multiple realizations of the underlying stochastic permeability field are conducted. Selected sensitivity studies are performed, including the effects of an alternative drift geometry representing a partially collapsed drift from an independent drift-degradation analysis (BSC 2004 [DIRS 166107]). The intended purpose of the seepage model is to provide results of drift-scale seepage rates under a series of parameters and scenarios in support of the Total System Performance Assessment for License Application (TSPA-LA). The SMPA is intended for the evaluation of drift-scale seepage rates under the full range of parameter values for three parameters found to be key (fracture permeability, the van Genuchten 1/a parameter, and percolation flux) and drift degradation shape scenarios in support of the TSPA-LA during the period of compliance for postclosure performance [Technical Work Plan for: Performance Assessment Unsaturated Zone (BSC 2002 [DIRS 160819], Section I-4-2-1)]. The flow-focusing model in the Topopah Spring welded (TSw) unit is intended to provide an estimate of flow focusing factors (FFFs) that (1) bridge the gap between the mountain-scale and drift-scale models, and (2) account for variability in local percolation flux due to

  8. [Contracts including performance and management of uncertainty].

    Science.gov (United States)

    Duru, G; Garassus, P; Auray, J-P

    2013-09-01

    Since many decades in France, the most important part of ambulatory health care expenditure is represented by drug consumption. By the fact, French patient is indeed the greatest world consumer of pharmaceuticals treatments. Therefore, the regulation authorities by successive strategies, attempt to limit or even restrict market access for new drugs in the health care sector secured by public social insurance coverage. Common objectives are to assess the reimbursement to scientific studies and to fix the price of therapeutics at an acceptable level for both industries and government. New trends try then to determine recently the drug price in a dual approach, as a component of global and effective contract, including performance and outcome. The first diffusion authorization is diffusion concerned, but this concept takes into account the eventual success of new produces in long-term survey. Signed for a fixed period as reciprocal partnership between regulation authorities and pharmaceutics industries, the contract integrates two dimensions of incertitude. The first one is represented by the strategy of new treatments development according to efficacy and adapted price, and the second one is linked to the result of diffusion and determines adapted rules if eventual non-respects of the previous engagement are registered. This paper discusses problems related to this new dimension of incertitude affected by conditional drug prices in market access strategy and the adapted follow-up of new treatment diffusion fixed by "outcome" contract between French regulation administration and pharmaceutics industries in our recent economic context. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  9. Resection of thymoma should include nodal sampling.

    Science.gov (United States)

    Weksler, Benny; Pennathur, Arjun; Sullivan, Jennifer L; Nason, Katie S

    2015-03-01

    Thymoma is best treated by surgical resection; however, no clear guidelines have been created regarding lymph node sampling at the time of resection. Additionally, the prognostic implications of nodal metastases are unclear. The aim of this study was to analyze the prognostic implications of nodal metastases in thymoma. The Surveillance, Epidemiology, and End Results database was queried for patients who underwent surgical resection of thymoma with documented pathologic examination of lymph nodes. The impact of nodal status on survival and thymoma staging was examined. We identified 442 patients who underwent thymoma resection with pathologic evaluation of 1 or more lymph nodes. A median of 2 nodes were sampled per patient. Fifty-nine patients (59 of 442, 13.3%) had ≥ 1 positive node. Patients with positive nodes were younger and had smaller tumors than node-negative patients. Median survival in the node-positive patients was 98 months, compared with 144 months in node-negative patients (P = .013). In multivariable analysis, the presence of positive nodes had a significant, independent, adverse impact on survival (hazard ratio 1.945, 95% confidence interval 1.296-2.919, P = .001). The presence of nodal metastases resulted in a change in classification to a higher stage in 80% of patients, the majority from Masaoka-Koga stage III to stage IV. Nodal status seems to be an important prognostic factor in patients with thymoma. Until the prognostic significance of nodal metastases is better understood, surgical therapy for thymoma should include sampling of regional lymph nodes. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  10. Gender-Related and Age-Related Differences in Implantable Defibrillator Recipients: Results From the Pacemaker and Implantable Defibrillator Leads Survival Study ("PAIDLESS").

    Science.gov (United States)

    Feldman, Alyssa M; Kersten, Daniel J; Chung, Jessica A; Asheld, Wilbur J; Germano, Joseph; Islam, Shahidul; Cohen, Todd J

    2015-12-01

    The purpose of this study was to investigate the influences of gender and age on defibrillator lead failure and patient mortality. The specific influences of gender and age on defibrillator lead failure have not previously been investigated. This study analyzed the differences in gender and age in relation to defibrillator lead failure and mortality of patients in the Pacemaker and Implantable Defibrillator Leads Survival Study ("PAIDLESS"). PAIDLESS includes all patients at Winthrop University Hospital who underwent defibrillator lead implantation between February 1, 1996 and December 31, 2011. Male and female patients were compared within each age decile, beginning at 15 years old, to analyze lead failure and patient mortality. Statistical analyses were performed using Wilcoxon rank-sum test, Fisher's exact test, Kaplan-Meier analysis, and multivariable Cox regression models. Pdefibrillator lead failure and patient mortality in relation to gender and age deciles at a single large implanting center. Within the 45 to 54 years group, leads implanted in women failed faster than in men. Male gender was found to be an independent protective factor in lead survival. This study emphasizes the complex interplay between gender and age with respect to implantable defibrillator lead failure and mortality.

  11. Pediatric crisis resource management training improves emergency medicine trainees' perceived ability to manage emergencies and ability to identify teamwork errors.

    Science.gov (United States)

    Bank, Ilana; Snell, Linda; Bhanji, Farhan

    2014-12-01

    Improved pediatric crisis resource management (CRM) training is needed in emergency medicine residencies because of the variable nature of exposure to critically ill pediatric patients during training. We created a short, needs-based pediatric CRM simulation workshop with postactivity follow-up to determine retention of CRM knowledge. Our aims were to provide a realistic learning experience for residents and to help the learners recognize common errors in teamwork and improve their perceived abilities to manage ill pediatric patients. Residents participated in a 4-hour objectives-based workshop derived from a formal needs assessment. To quantify their subjective abilities to manage pediatric cases, the residents completed a postworkshop survey (with a retrospective precomponent to assess perceived change). Ability to identify CRM errors was determined via a written assessment of scripted errors in a prerecorded video observed before and 1 month after completion of the workshop. Fifteen of the 16 eligible emergency medicine residents (postgraduate year 1-5) attended the workshop and completed the surveys. There were significant differences in 15 of 16 retrospective pre to post survey items using the Wilcoxon rank sum test for non-parametric data. These included ability to be an effective team leader in general (P CRM errors through the use of the video assessment from 3 of the 12 CRM errors to 7 of the 12 CRM errors (P CRM simulation-based workshop improved the residents' self-perceptions of their pediatric CRM abilities and improved their performance on a video assessment task.

  12. The effects of soy supplementation on gene expression in breast cancer: a randomized placebo-controlled study.

    Science.gov (United States)

    Shike, Moshe; Doane, Ashley S; Russo, Lianne; Cabal, Rafael; Reis-Filho, Jorge S; Gerald, William; Cody, Hiram; Khanin, Raya; Bromberg, Jacqueline; Norton, Larry

    2014-09-01

    There are conflicting reports on the impact of soy on breast carcinogenesis. This study examines the effects of soy supplementation on breast cancer-related genes and pathways. Women (n = 140) with early-stage breast cancer were randomly assigned to soy protein supplementation (n = 70) or placebo (n = 70) for 7 to 30 days, from diagnosis until surgery. Adherence was determined by plasma isoflavones: genistein and daidzein. Gene expression changes were evaluated by NanoString in pre- and posttreatment tumor tissue. Genome-wide expression analysis was performed on posttreatment tissue. Proliferation (Ki67) and apoptosis (Cas3) were assessed by immunohistochemistry. Plasma isoflavones rose in the soy group (two-sided Wilcoxon rank-sum test, P 2-fold) of cell cycle transcripts, including those that promote cell proliferation, such as FGFR2, E2F5, BUB1, CCNB2, MYBL2, CDK1, and CDC20 (P Ki67 or Cas3. Gene expression associated with soy intake and high plasma genistein defines a signature characterized by overexpression of FGFR2 and genes that drive cell cycle and proliferation pathways. These findings raise the concerns that in a subset of women soy could adversely affect gene expression in breast cancer. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Pattern of optometry practice and range of services in India.

    Science.gov (United States)

    Thite, Nilesh; Jaggernath, Jyoti; Chinanayi, Farai; Bharadwaj, Shrikant; Kunjeer, Gauri

    2015-05-01

    This study was conducted to evaluate the range of services provided by optometrists in various modes of optometric practice in India. An online questionnaire was administered to 1674 optometrists to collect information on the range of optometric services offered. Data were analyzed based on variables including sex, educational qualification, and modes of practice. Two-sample Wilcoxon rank sum tests, χ tests, and Fisher exact text were used to conduct inferential statistics. A total of 563 valid and completed survey questionnaires were received from graduates of 41 optometry institutes working across 23 states of India. Of these, 225 (40.0%) were female, 288 (51.2%) had completed postgraduate education, and 340 (60.5%) were involved in more than one mode of practice. The top three modes of practice were hospital-based practice (44.8%), academia (42.8%), and optical retail (33.0%). Of the 441, out of 563 (78.3%) respondents involved in patient care, the majority (98.4%) performed refraction and routine eye examination, 70.3% dispensed contact lenses, and 66.9% practiced optical dispensing. Lower involvement was seen in providing binocular-vision (45.1%) and low-vision services (30.2%). Higher education was associated with advanced level of practice (p need to be more involved in providing the core optometric services of binocular vision and low vision. Higher education has an impact on the level of optometric practice.

  14. Effects of physiologic testosterone therapy on quality of life, self-esteem, and mood in women with primary ovarian insufficiency.

    Science.gov (United States)

    Guerrieri, Gioia M; Martinez, Pedro E; Klug, Summer P; Haq, Nazli A; Vanderhoof, Vien H; Koziol, Deloris E; Popat, Vaishali B; Kalantaridou, Sophia N; Calis, Karim A; Rubinow, David R; Schmidt, Peter J; Nelson, Lawrence M

    2014-09-01

    Women with primary ovarian insufficiency (POI) display low androgen levels, which could contribute to mood and behavioral symptoms observed in this condition. We examined the effects of physiologic testosterone therapy added to standard estrogen/progestin therapy on quality of life, self-esteem, and mood in women with POI. One hundred twenty-eight women with 46,XX spontaneous POI participated in a 12-month randomized, placebo-controlled, parallel-design investigation of the efficacy of testosterone augmentation of estrogen/progestin therapy. Quality of life, self-esteem, and mood symptoms were evaluated with standardized rating scales and a structured clinical interview. Differences in outcome measures between the testosterone and placebo treatments were analyzed by Wilcoxon rank sum tests. No differences in baseline characteristics, including serum hormone levels (P > 0.05), were found. Baseline mean (SD) Center for Epidemiologic Studies Depression Scale scores were 10.7 (8.6) and 9.2 (7.8) for testosterone and placebo, respectively (P = 0.35). After 12 months of treatment, measures of quality of life, self-esteem, and mood symptoms did not differ between treatment groups. Serum testosterone levels achieved physiologic levels in the testosterone group and were significantly higher compared with placebo (P self-esteem and had minimal effects on mood. Other mechanisms might play a role in the altered mood accompanying this disorder.

  15. Statistical application of groundwater monitoring data at the Hanford Site

    International Nuclear Information System (INIS)

    Chou, C.J.; Johnson, V.G.; Hodges, F.N.

    1993-09-01

    Effective use of groundwater monitoring data requires both statistical and geohydrologic interpretations. At the Hanford Site in south-central Washington state such interpretations are used for (1) detection monitoring, assessment monitoring, and/or corrective action at Resource Conservation and Recovery Act sites; (2) compliance testing for operational groundwater surveillance; (3) impact assessments at active liquid-waste disposal sites; and (4) cleanup decisions at Comprehensive Environmental Response Compensation and Liability Act sites. Statistical tests such as the Kolmogorov-Smirnov two-sample test are used to test the hypothesis that chemical concentrations from spatially distinct subsets or populations are identical within the uppermost unconfined aquifer. Experience at the Hanford Site in applying groundwater background data indicates that background must be considered as a statistical distribution of concentrations, rather than a single value or threshold. The use of a single numerical value as a background-based standard ignores important information and may result in excessive or unnecessary remediation. Appropriate statistical evaluation techniques include Wilcoxon rank sum test, Quantile test, ''hot spot'' comparisons, and Kolmogorov-Smirnov types of tests. Application of such tests is illustrated with several case studies derived from Hanford groundwater monitoring programs. To avoid possible misuse of such data, an understanding of the limitations is needed. In addition to statistical test procedures, geochemical, and hydrologic considerations are integral parts of the decision process. For this purpose a phased approach is recommended that proceeds from simple to the more complex, and from an overview to detailed analysis

  16. The Effects of Soy Supplementation on Gene Expression in Breast Cancer: A Randomized Placebo-Controlled Study

    Science.gov (United States)

    Doane, Ashley S.; Russo, Lianne; Cabal, Rafael; Reis-Filho, Jorge S.; Gerald, William; Cody, Hiram; Khanin, Raya; Bromberg, Jacqueline; Norton, Larry

    2014-01-01

    Background There are conflicting reports on the impact of soy on breast carcinogenesis. This study examines the effects of soy supplementation on breast cancer-related genes and pathways. Methods Women (n = 140) with early-stage breast cancer were randomly assigned to soy protein supplementation (n = 70) or placebo (n = 70) for 7 to 30 days, from diagnosis until surgery. Adherence was determined by plasma isoflavones: genistein and daidzein. Gene expression changes were evaluated by NanoString in pre- and posttreatment tumor tissue. Genome-wide expression analysis was performed on posttreatment tissue. Proliferation (Ki67) and apoptosis (Cas3) were assessed by immunohistochemistry. Results Plasma isoflavones rose in the soy group (two-sided Wilcoxon rank-sum test, P 2-fold) of cell cycle transcripts, including those that promote cell proliferation, such as FGFR2, E2F5, BUB1, CCNB2, MYBL2, CDK1, and CDC20 (P Soy intake did not result in statistically significant changes in Ki67 or Cas3. Conclusions Gene expression associated with soy intake and high plasma genistein defines a signature characterized by overexpression of FGFR2 and genes that drive cell cycle and proliferation pathways. These findings raise the concerns that in a subset of women soy could adversely affect gene expression in breast cancer. PMID:25190728

  17. Stiffness, strength, and failure modes of implant-supported monolithic lithium disilicate crowns: influence of titanium and zirconia abutments.

    Science.gov (United States)

    Joda, Tim; Bürki, Alexander; Bethge, Stefan; Brägger, Urs; Zysset, Philippe

    2015-01-01

    The objective of this study was to evaluate stiffness, strength, and failure modes of monolithic crowns produced using computer-aided design/computer-assisted manufacture, which are connected to diverse titanium and zirconia abutments on an implant system with tapered, internal connections. Twenty monolithic lithium disilicate (LS2) crowns were constructed and loaded on bone level-type implants in a universal testing machine under quasistatic conditions according to DIN ISO 14801. Comparative analysis included a 2 × 2 format: prefabricated titanium abutments using proprietary bonding bases (group A) vs nonproprietary bonding bases (group B), and customized zirconia abutments using proprietary Straumann CARES (group C) vs nonproprietary Astra Atlantis (group D) material. Stiffness and strength were assessed and calculated statistically with the Wilcoxon rank sum test. Cross-sections of each tested group were inspected microscopically. Loaded LS2 crowns, implants, and abutment screws in all tested specimens (groups A, B, C, and D) did not show any visible fractures. For an analysis of titanium abutments (groups A and B), stiffness and strength showed equally high stability. In contrast, proprietary and nonproprietary customized zirconia abutments exhibited statistically significant differences with a mean strength of 366 N (Astra) and 541 N (CARES) (P zirconia abutments (groups C and D) below the implant shoulder. Depending on the abutment design, prefabricated titanium abutment and proprietary customized zirconia implant-abutment connections in conjunction with monolithic LS2 crowns had the best results in this laboratory investigation.

  18. Feature Selection and Predictors of Falls with Foot Force Sensors Using KNN-Based Algorithms

    Directory of Open Access Journals (Sweden)

    Shengyun Liang

    2015-11-01

    Full Text Available The aging process may lead to the degradation of lower extremity function in the elderly population, which can restrict their daily quality of life and gradually increase the fall risk. We aimed to determine whether objective measures of physical function could predict subsequent falls. Ground reaction force (GRF data, which was quantified by sample entropy, was collected by foot force sensors. Thirty eight subjects (23 fallers and 15 non-fallers participated in functional movement tests, including walking and sit-to-stand (STS. A feature selection algorithm was used to select relevant features to classify the elderly into two groups: at risk and not at risk of falling down, for three KNN-based classifiers: local mean-based k-nearest neighbor (LMKNN, pseudo nearest neighbor (PNN, local mean pseudo nearest neighbor (LMPNN classification. We compared classification performances, and achieved the best results with LMPNN, with sensitivity, specificity and accuracy all 100%. Moreover, a subset of GRFs was significantly different between the two groups via Wilcoxon rank sum test, which is compatible with the classification results. This method could potentially be used by non-experts to monitor balance and the risk of falling down in the elderly population.

  19. Institutional Variation in the Promotion of Racial/Ethnic Minority Faculty at US Medical Schools

    Science.gov (United States)

    Ciarleglio, Maria M.; Sandoval-Schaefer, Teresa; Elumn, Johanna; Castillo-Page, Laura; Peduzzi, Peter; Bradley, Elizabeth H.

    2012-01-01

    Objectives. We compared faculty promotion rates by race/ethnicity across US academic medical centers. Methods. We used the Association of American Medical College's 1983 through 2000 faculty roster data to estimate median institution-specific promotion rates for assistant professor to associate professor and for associate professor to full professor. In unadjusted analyses, we compared medians for Hispanic and Black with White faculty using the Wilcoxon rank sum test. We compared institution-specific promotion rates between racial/ethnic groups with data stratified by institutional characteristic (institution size, proportion racial/ethnic minority faculty, and proportion women faculty) using the χ2 test. Our sample included 128 academic medical centers and 88 432 unique faculty. Results. The median institution-specific promotion rates for White, Hispanic, and Black faculty, respectively, were 30.2%, 23.5%, and 18.8% (P climates that support the successful development of racial/ethnic minority trainees, ultimately improving healthcare access and quality for all patients. PMID:22420820

  20. Companion Animal Owner Perceptions, Knowledge, and Beliefs Regarding Pain Management in End-of-Life Care.

    Science.gov (United States)

    Heuberger, Roschelle; Petty, Michael; Huntingford, Janice

    2016-12-01

    The senior companion animal is the fastest growing segment of the pet population. End-of-life care, quality of life, and pain management (PM) are extremely important to pet owners. Research into PM and end-of-life care is essential due to lack of information on owner knowledge, attitudes, and beliefs. A survey was developed to gather information from owners. Surveys were developed using expert focus groups, and participants were recruited through social media. Survey validation employed emergent themes and grounded theory. Data from respondents (n = 986) were analyzed using descriptive statistics, Kruskal-Wallis, Jonckheere-Terpstra, or Wilcoxon rank-sum tests, with post hoc adjustment. Approximately 87% of respondents felt that euthanizing for unmitigated pain was appropriate. Households where there were multiple pets, both cats and dogs, and owners who were not first-time pet owners showed even greater preferences (P owners lacked knowledge and had unrealistic attitudes and beliefs about treatment options, costs, and long-term feasibility. Limitations of this research included homogeneity of online survey respondents and convenience sampling. Translational research should be fostered to increase the availability and affordability of PM techniques in veterinary practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Ventilation/perfusion SPECT or SPECT/CT for lung function imaging in patients with pulmonary emphysema?

    Science.gov (United States)

    Froeling, Vera; Heimann, Uwe; Huebner, Ralf-Harto; Kroencke, Thomas J; Maurer, Martin H; Doellinger, Felix; Geisel, Dominik; Hamm, Bernd; Brenner, Winfried; Schreiter, Nils F

    2015-07-01

    To evaluate the utility of attenuation correction (AC) of V/P SPECT images for patients with pulmonary emphysema. Twenty-one patients (mean age 67.6 years) with pulmonary emphysema who underwent V/P SPECT/CT were included. AC/non-AC V/P SPECT images were compared visually and semiquantitatively. Visual comparison of AC/non-AC images was based on a 5-point likert scale. Semiquantitative comparison assessed absolute counts per lung (aCpLu) and lung lobe (aCpLo) for AC/non-AC images using software-based analysis; percentage counts (PC = (aCpLo/aCpLu) × 100) were calculated. Correlation between AC/non-AC V/P SPECT images was analyzed using Spearman's rho correlation coefficient; differences were tested for significance with the Wilcoxon rank sum test. Visual analysis revealed high conformity for AC and non-AC V/P SPECT images. Semiquantitative analysis of PC in AC/non-AC images had an excellent correlation and showed no significant differences in perfusion (ρ = 0.986) or ventilation (ρ = 0.979, p = 0.809) SPECT/CT images. AC of V/P SPECT images for lung lobe-based function imaging in patients with pulmonary emphysema do not improve visual or semiquantitative image analysis.

  2. [The counseling of nursing decreases symptomatology and relapses in pediatric patients with allergic rhinitis].

    Science.gov (United States)

    Solís-Flores, Laura; Acuña-Rojas, Rosalinda; López-Medina, Leobardo; Meléndez-Mier, Guillermo

    Allergic rhinitis (AR) is considered to be a public health problem, therefore it is essential to test health education strategies such as nursing counseling (NC) aimed at population groups such as children with allergic rhinitis and their tutors. This study aimed to measure the health benefits of children with this disease for a year. Longitudinal, randomized, comparative study with a sample of 100 pediatric patients of both sexes, aged 6 to 12 years, with diagnosis of allergic rhinitis, with counseling (study group) and without counseling (control group). In both groups, an informed consent letter signed by both tutors was obtained, in addition to knowledge and assessment papers; the latter included a scale of symptomatology and Morisky Green (adherence to treatment). The children in the study group received intervention based on personalized education, didactic material, support of the multidisciplinary group if necessary (doctor, dermatologist and psychologist). The control group received usual care. In both groups, telephone follow-up was performed, which allowed the number of relapses to be identified in one year. The Wilcoxon rank-sum test (Mann-Whitney) was used to compare the results; the presence of relapses in the control group was statistically significant compared to the study group. It was found that the infant population that receives NC, has as a better benefit the control of the symptomatology and decrease of relapses per year. Copyright © 2017. Publicado por Masson Doyma México S.A.

  3. Differences in pediatric dental services under general anesthesia for Medicaid and military dependent children.

    Science.gov (United States)

    Johnson, M B; Cappelli, D P; Bradshaw, B S; Mabry, J C

    2010-01-01

    This study's purpose was to compare pediatric dental services provided for Medicaid and military dependent children to determine if differences in dental treatment choices exist based on site and payment method. Subjects included 120 Medicaid patients at the University of Texas Health Science Center at San Antonio and 120 military dependents at Lackland Air Force Base, Texas. Demographic data and treatment information were abstracted for children younger than 6 years old receiving dental treatment under general anesthesia between 2002 and 2006. Data was analyzed using Wilcoxon rank sum, Kruskal-Wallis, and Fisher's exact tests. The Medicaid recipients were younger (40.2 vs 49.8 months, Psealants (P<.001). Age and gender did not affect decay rates, but those of Hispanic ethnicity did experience more decay than non-Hispanics (9.5 vs 8.6, P=.02). This study found no difference in the number of less conservative, albeit more costly, procedures performed with Medicaid children at a university compared to military dependents at a military base.

  4. Internet Versus DVD Decision Aids for Hip and Knee Osteoarthritis.

    Science.gov (United States)

    Allen, Kelli D; Sanders, Linda L; Olsen, Maren K; Bowlby, Lynn; Katz, Jeffrey N; Mather, Richard C; Williams, John W

    2016-06-01

    Decision aids (DAs) can improve multiple decision-making outcomes, but it is not known whether different formats of delivery differ in their effectiveness or acceptability. The present study compared the effectiveness and acceptability of internet and DVD formats of DAs for osteoarthritis (OA). Patients with hip or knee OA were randomized to view an internet or DVD format DA, which provided information on OA treatments. Measures were collected at baseline, immediately after viewing the DA and then 30 days later. Outcomes included: Hip/Knee OA Decision Quality Instrument - Knowledge Subscale (HK-DQI Knowledge), Decisional Conflict Scale (DCS), Preparation for Decision Making Scale (PDMS), Stage of Decision Making, and Acceptability of DAs. Generalized estimating equations (GEE) were used to examine changes in HK-DQI Knowledge and DCS scores over time, between decision aid groups and within the sample overall. Group differences in the PDMS scale (assessed once, immediately after DA viewing) were estimated using a Wilcoxon rank sums test. Among 155 participants in the study, the mean age was 61.8 years, 60.6% were women and 58.1% were Caucasian. HK-DQI Knowledge scores improved over time (p John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Characterization of gait in female patients with moderate to severe hallux valgus deformity.

    Science.gov (United States)

    Chopra, S; Moerenhout, K; Crevoisier, X

    2015-07-01

    Hallux valgus is one of the most common forefoot problems in females. Studies have looked at gait alterations due to hallux valgus deformity, assessing temporal, kinematic or plantar pressure parameters individually. The present study, however, aims to assess all listed parameters at once and to isolate the most clinically relevant gait parameters for moderate to severe hallux valgus deformity with the intent of improving post-operative patient prognosis and rehabilitation. The study included 26 feet with moderate to severe hallux valgus deformity and 30 feet with no sign of hallux valgus in female participants. Initially, weight bearing radiographs and foot and ankle clinical scores were assessed. Gait assessment was then performed utilizing pressure insoles (PEDAR) and inertial sensors (Physilog) and the two groups were compared using a non-parametric statistical hypothesis test (Wilcoxon rank sum, Phallux valgus group compared to controls and 9 gait parameters (effect size between 1.03 and 1.76) were successfully isolated to best describe the altered gait in hallux valgus deformity (r(2)=0.71) as well as showed good correlation with clinical scores. Our results, and nine listed parameters, could serve as benchmark for characterization of hallux valgus and objective evaluation of treatment efficacy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Content and style comparison of physician communication in teledermatology and in-person visits.

    Science.gov (United States)

    Edison, Karen E; Fleming, David A; Nieman, Elizabeth Lewis; Stine, Kendra; Chance, Louanne; Demiris, George

    2013-07-01

    The body of research is rapidly growing regarding the use of telemedicine in patient care, including cost-effectiveness, patient access, patient outcomes, etc. Less has been done describing physician communication during different aspects of the clinical visit (i.e., education, assessment, treatment, etc.) during actual versus virtual patient visits. The purpose of this study was to evaluate dermatology healthcare providers' communication via both modalities with regard to content and style. In-person and teledermatology patient visits were observed, audio-recorded, and transcribed over an 8-month period. A content analysis was performed. The Wilcoxon rank sum test was used to compare the content differences between visit modalities for each category. A p value of 0.05 was considered as significant for all tests. There were no statistically significant differences between modalities in the average number of physician words in seven of eight communication categories: small talk, clinical assessment, psychosocial issues, patient education, patient compliance, patient treatment, and administrative issues (p value range, 0.16-0.91). As well, the same communication themes occurred in each modality to essentially the same degree. For instance, assessment and discussion of treatment occurred in 100% of in-person and teledermatology visits, as did small talk. This research indicates that physician providers communicate with similar style and content whether using teledermatology or in-person.

  7. integIRTy: a method to identify genes altered in cancer by accounting for multiple mechanisms of regulation using item response theory.

    Science.gov (United States)

    Tong, Pan; Coombes, Kevin R

    2012-11-15

    Identifying genes altered in cancer plays a crucial role in both understanding the mechanism of carcinogenesis and developing novel therapeutics. It is known that there are various mechanisms of regulation that can lead to gene dysfunction, including copy number change, methylation, abnormal expression, mutation and so on. Nowadays, all these types of alterations can be simultaneously interrogated by different types of assays. Although many methods have been proposed to identify altered genes from a single assay, there is no method that can deal with multiple assays accounting for different alteration types systematically. In this article, we propose a novel method, integration using item response theory (integIRTy), to identify altered genes by using item response theory that allows integrated analysis of multiple high-throughput assays. When applied to a single assay, the proposed method is more robust and reliable than conventional methods such as Student's t-test or the Wilcoxon rank-sum test. When used to integrate multiple assays, integIRTy can identify novel-altered genes that cannot be found by looking at individual assay separately. We applied integIRTy to three public cancer datasets (ovarian carcinoma, breast cancer, glioblastoma) for cross-assay type integration which all show encouraging results. The R package integIRTy is available at the web site http://bioinformatics.mdanderson.org/main/OOMPA:Overview. kcoombes@mdanderson.org. Supplementary data are available at Bioinformatics online.

  8. Application of survival analysis methodology to the quantitative analysis of LC-MS proteomics data

    KAUST Repository

    Tekwe, C. D.

    2012-05-24

    MOTIVATION: Protein abundance in quantitative proteomics is often based on observed spectral features derived from liquid chromatography mass spectrometry (LC-MS) or LC-MS/MS experiments. Peak intensities are largely non-normal in distribution. Furthermore, LC-MS-based proteomics data frequently have large proportions of missing peak intensities due to censoring mechanisms on low-abundance spectral features. Recognizing that the observed peak intensities detected with the LC-MS method are all positive, skewed and often left-censored, we propose using survival methodology to carry out differential expression analysis of proteins. Various standard statistical techniques including non-parametric tests such as the Kolmogorov-Smirnov and Wilcoxon-Mann-Whitney rank sum tests, and the parametric survival model and accelerated failure time-model with log-normal, log-logistic and Weibull distributions were used to detect any differentially expressed proteins. The statistical operating characteristics of each method are explored using both real and simulated datasets. RESULTS: Survival methods generally have greater statistical power than standard differential expression methods when the proportion of missing protein level data is 5% or more. In particular, the AFT models we consider consistently achieve greater statistical power than standard testing procedures, with the discrepancy widening with increasing missingness in the proportions. AVAILABILITY: The testing procedures discussed in this article can all be performed using readily available software such as R. The R codes are provided as supplemental materials. CONTACT: ctekwe@stat.tamu.edu.

  9. Lichen planus affecting the female genitalia: A retrospective review of patients at Mayo Clinic.

    Science.gov (United States)

    Fahy, Caoimhe M R; Torgerson, Rochelle R; Davis, Mark D P

    2017-12-01

    Genital or vulval lichen planus (VLP) may have a disabling effect on a patient's quality of life. Evidence-based management guidelines are lacking for VLP. We sought to review clinical presentation and treatment of patients who received a diagnosis of VLP. The 100 consecutive patients who received a diagnosis of VLP at Mayo Clinic between January 1, 1997, and December 31, 2015, were reviewed retrospectively. Descriptive statistics were used for data analysis. Fisher's exact test and the Wilcoxon rank sum test were used for analysis of categorical and continuous variables, respectively. All statistical tests were 2 sided, with the α level set at .05 for statistical significance. The time to diagnosis for 49% of patients was more than 1 year. Three patients (3%) had vulval dysplasia, including invasive squamous cell carcinoma. Sixty-eight patients (68%) had multisite lichen planus disease. Eleven patients (11%) had disease remission. Dermatology was the lead specialty for 9 of these cases of remission. This was a retrospective, small-cohort study. A low frequency of disease remission was seen in patients with VLP. Patients with lichen planus benefit considerably from dermatology consultation. Further research is warranted to establish high-quality, evidence-based guidelines for multidisciplinary management of this challenging disease. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  10. Acquired urethral obstruction in New World camelids: 34 cases (1995-2008).

    Science.gov (United States)

    Duesterdieck-Zellmer, K F; Van Metre, D C; Cardenas, A; Cebra, C K

    2014-08-01

    Document the clinical features, short- and long-term outcomes and prognostic factors in New World camelids with acquired urethral obstruction. Retrospective case study. Case data from medical records of 34 New World camelids presenting with acquired urethral obstruction were collected and follow-up information on discharged patients was obtained. Associations with short- and long-term survival were evaluated using Wilcoxon rank-sum tests, exact-logistic regressions and Kaplan-Meier survival curves. Of the 34 New World camelids 23 were intact males and 11 were castrated; 4 animals were euthanased upon presentation, 7 were treated medically and 23 surgically, including urethrotomy, bladder marsupialisation, tube cystostomy alone or combined with urethrotomy, urethrostomy or penile reefing. Necrosis of the distal penis was found in 4 animals and all were short-term non-survivors. Short-term survival for surgical cases was 65%, and 57% for medical cases. Incomplete urethral obstruction at admission and surgical treatment were associated with increased odds of short-term survival. Of 14 records available for long-term follow-up, 6 animals were alive and 8 were dead (median follow-up 4.5 years, median survival time 2.5 years). Recurrence of urethral obstruction was associated with long-term non-survival. Surgically treated New World camelids with incomplete urethral obstruction have the best odds of short-term survival and those with recurrence of urethral obstruction have a poor prognosis for long-term survival. © 2014 Australian Veterinary Association.

  11. Width of keratinized gingiva and the health status of the supporting tissues around dental implants.

    Science.gov (United States)

    Bouri, Anil; Bissada, Nabil; Al-Zahrani, Mohammad S; Faddoul, Fady; Nouneh, Imad

    2008-01-01

    This cross-sectional study was performed to determine whether an association exists between the width of keratinized mucosa and the health of implant-supporting tissues. Data on 200 dental implants were collected. Periodontal parameters measured included Plaque Index, Gingival Index, width of keratinized mucosa, thickness of keratinized mucosa, radiographic bone level, and bleeding on probing. Statistical analysis was accomplished with the t test, Wilcoxon rank sum test, and logistic and linear regression models. Significance was established when P was less than .05. The mean Gingival Index score, Plaque Index score, and radiographic bone loss were significantly higher for those implants with a narrow zone (Implants with a narrow zone of keratinized mucosa also were more likely to bleed upon probing, even after adjusting for Plaque Index, smoking, thickness of the gingiva, and time since implant placement (adjusted odds ratio, 2.37; 95% confidence interval, 1.04 to 5.83). Significant independent association also was found between the width of keratinized mucosa and radiographic bone loss in favor of wider zone of keratinized mucosa. Increased width of keratinized mucosa around implants is associated with lower mean alveolar bone loss and improved indices of soft tissue health.

  12. An Integrated Biochemistry Laboratory, Including Molecular Modeling

    Science.gov (United States)

    Hall, Adele J. Wolfson Mona L.; Branham, Thomas R.

    1996-11-01

    The dilemma of designing an advanced undergraduate laboratory lies in the desire to teach and reinforce basic principles and techniques while at the same time exposing students to the excitement of research. We report here on a one-semester, project-based biochemistry laboratory that combines the best features of a cookbook approach (high success rate, achievement of defined goals) with those of an investigative, discovery-based approach (student involvement in the experimental design, excitement of real research). Individual modules may be selected and combined to meet the needs of different courses and different institutions. The central theme of this lab is protein purification and design. This laboratory accompanies the first semester of biochemistry (Structure and Function of Macromolecules, a course taken mainly by junior and senior chemistry and biological chemistry majors). The protein chosen as the object of study is the enzyme lysozyme, which is utilized in all projects. It is suitable for a student lab because it is easily and inexpensively obtained from egg white and is extremely stable, and its high isoelectric point (pI = 11) allows for efficient separation from other proteins by ion-exchange chromatography. Furthermore, a literature search conducted by the resourceful student reveals a wealth of information, since lysozyme has been the subject of numerous studies. It was the first enzyme whose structure was determined by crystallography (1). Hendrickson et al. (2) have previously described an intensive one-month laboratory course centered around lysozyme, although their emphasis is on protein stability rather than purification and engineering. Lysozyme continues to be the focus of much exciting new work on protein folding and dynamics, structure and activity (3 - 5). This lab course includes the following features: (i) reinforcement of basic techniques, such as preparation of buffers, simple enzyme kinetics, and absorption spectroscopy; (ii

  13. Ionic liquids, electrolyte solutions including the ionic liquids, and energy storage devices including the ionic liquids

    Science.gov (United States)

    Gering, Kevin L.; Harrup, Mason K.; Rollins, Harry W.

    2015-12-08

    An ionic liquid including a phosphazene compound that has a plurality of phosphorus-nitrogen units and at least one pendant group bonded to each phosphorus atom of the plurality of phosphorus-nitrogen units. One pendant group of the at least one pendant group comprises a positively charged pendant group. Additional embodiments of ionic liquids are disclosed, as are electrolyte solutions and energy storage devices including the embodiments of the ionic liquid.

  14. Prospective assessment of deep inspiration breath-hold using 3-dimensional surface tracking for irradiation of left-sided breast cancer.

    Science.gov (United States)

    Tanguturi, Shyam K; Lyatskaya, Yulia; Chen, Yuhui; Catalano, Paul J; Chen, Ming Hui; Yeo, Wee-Pin; Marques, Alex; Truong, Linh; Yeh, Mary; Orlina, Lawrence; Wong, Julia S; Punglia, Rinaa S; Bellon, Jennifer R

    2015-01-01

    Deep inspiration breath hold (DIBH) is used to decrease cardiac irradiation during radiation therapy (RT) for breast cancer. The patients most likely to benefit and the impact on treatment time remain largely unknown. We sought to identify predictors for the use of DIBH and to quantify differences in dosimetry and treatment time using a prospective registry. A total of 150 patients with left breast cancer were enrolled. All patients were simulated with both free breathing (FB) and DIBH. RT was delivered by either modality. Alternate scans were planned with use of deformable registration to include identical RT volumes. DIBH patients were monitored by a real-time surface tracking system, AlignRT (Vision RT, Ltd, London, United Kingdom). Baseline characteristics and treatment times were compared by Fisher exact test and Wilcoxon rank sum test. Dosimetric endpoints were analyzed by Wilcoxon signed rank test, and linear regression identified predictors for change in mean heart dose (∆MHD). We treated 38 patients with FB and 110 with DIBH. FB patients were older, more likely to have heart and lung disease, and less likely to receive chemotherapy or immediate reconstruction (all P 20 cGy improvement in MHD in 107 patients but a >20 cGy increase in MHD in 14. Both MHD and lung V20 were significantly lower in DIBH than in paired FB plans. On multivariate analysis, younger age (4.18 cGy per year; P < .0001), higher body mass index (6.06 cGy/kg/m(2); P = .0018), and greater change in lung volumes (130 cGy/L; P = .003) were associated with greater ∆MHD. DIBH improves cardiac dosimetry without significantly impacting treatment time in most patients. Greater inspiratory lung volumes augment this benefit. Because the improvement with DIBH was not uniform, patients should be scanned with both FB and DIBH. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  15. Characteristics of corneal ectasia after LASIK for myopia.

    Science.gov (United States)

    Twa, Michael D; Nichols, Jason J; Joslin, Charlotte E; Kollbaum, Pete S; Edrington, Timothy B; Bullimore, Mark A; Mitchell, G Lynn; Cruickshanks, Karen J; Schanzlin, David J

    2004-07-01

    There are numerous reports of corneal ectasia after laser in situ keratomileusis (LASIK) for myopia without a consistent definition of this condition or a definitive etiology. We conducted a retrospective analysis of published case reports to describe common characteristics of this postoperative event and compared them with findings from a group of successful LASIK patients. A MEDLINE search for "LASIK" and "ectasia" yielded 21 relevant articles published before May 2003 (n = 86 eyes, 59 patients). A comparison group (n = 103 eyes, 63 patients) was selected from a clinic-based sample of successful LASIK patients with 12 months of follow-up after treatment. Descriptive statistics are reported as median and interquartile range. Comparisons were performed using the Wilcoxon rank sum, Wilcoxon signed rank, and chi-square tests. Time to diagnosis of ectasia after LASIK was 13 months (6 to 20 months). Residual myopia in the ectasia group was -3.69 D (-6.00 to -2.13 D) and was significantly greater than the comparison group, -0.38 D (-0.75 to 0.00 D), P ectasia had increased corneal toricity 2.87 D (2.00 to 4.9 D) with increased oblique astigmatism 1.3 D (0.23 to 2.89 D) relative to eyes in the comparison group 0.00 D (0.00 to 0.08 D), and a loss of 2 lines (-0.5 to -6 lines) of best spectacle-corrected visual acuity (all P corneal transplantation. Preoperative characteristics of corneal ectasia include worse visual acuity, less corneal thickness, greater residual myopia, and greater corneal toricity than nonectatic eyes. Treatment factors associated with corneal ectasia after LASIK are greater stromal ablation and less residual stromal bed thickness. Postoperative characteristics of corneal ectasia are myopic refractive error with increased astigmatism, worse spectacle-corrected visual acuity, increased corneal toricity with topographic abnormality, and progressive corneal thinning.

  16. SU-E-J-249: Characterization of Gynecological Tumor Heterogeneity Using Texture Analysis in the Context of An 18F-FDG PET Adaptive Protocol

    Energy Technology Data Exchange (ETDEWEB)

    Nawrocki, J [Duke University Medical Physics Graduate Program, Durham, NC (United States); Chino, J; Craciunescu, O [Duke University Medical Center Department of Radiation Oncology, Durham, NC (United States); Das, S [University of North Carolina School of Medicine, Chapel Hill, NC (United States)

    2015-06-15

    Purpose: We propose a method to examine gynecological tumor heterogeneity using texture analysis in the context of an adaptive PET protocol in order to establish if texture metrics from baseline PET-CT predict tumor response better than SUV metrics alone as well as determine texture features correlating with tumor response during radiation therapy. Methods: This IRB approved protocol included 29 women with node positive gynecological cancers visible on FDG-PET treated with EBRT to the PET positive nodes. A baseline and intra-treatment PET-CT was obtained. Tumor outcome was determined based on RECIST on posttreatment PET-CT. Primary GTVs were segmented using 40% threshold and a semi-automatic gradient-based contouring tool, PET Edge (MIM Software Inc., Cleveland, OH). SUV histogram features, Metabolic Volume (MV), and Total Lesion Glycolysis (TLG) were calculated. Four 3D texture matrices describing local and regional relationships between voxel intensities in the GTV were generated: co-occurrence, run length, size zone, and neighborhood difference. From these, 39 texture features were calculated. Prognostic power of baseline features derived from gradientbased and threshold GTVs were determined using the Wilcoxon rank-sum test. Receiver Operating Characteristics and logistic regression was performed using JMP (SAS Institute Inc., Cary, NC) to find probabilities of predicting response. Changes in features during treatment were determined using the Wilcoxon signed-rank test. Results: Of the 29 patients, there were 16 complete responders, 7 partial responders, and 6 non-responders. Comparing CR/PR vs. NR for gradient-based GTVs, 7 texture values, TLG, and SUV kurtosis had a p < 0.05. Threshold GTVs yielded 4 texture features and TLG with p < 0.05. From baseline to intra-treatment, 14 texture features, SUVmean, SUVmax, MV, and TLG changed with p < 0.05. Conclusion: Texture analysis of PET imaged gynecological tumors is an effective method for early prognosis and should

  17. Pulmonary Function After Treatment for Embryonal Brain Tumors on SJMB03 That Included Craniospinal Irradiation

    International Nuclear Information System (INIS)

    Green, Daniel M.; Merchant, Thomas E.; Billups, Catherine A.; Stokes, Dennis C.; Broniscer, Alberto; Bartels, Ute; Chintagumpala, Murali; Hassall, Timothy E.; Gururangan, Sridharan; McCowage, Geoffrey B.; Heath, John A.; Cohn, Richard J.; Fisher, Michael J.; Srinivasan, Ashok; Robinson, Giles W.; Gajjar, Amar

    2015-01-01

    Purpose: The treatment of children with embryonal brain tumors (EBT) includes craniospinal irradiation (CSI). There are limited data regarding the effect of CSI on pulmonary function. Methods: Protocol SJMB03 enrolled patients 3 to 21 years of age with EBT. Pulmonary function tests (PFTs) (forced expiratory volume in 1 second [FEV 1 ] and forced vital capacity [FVC] by spirometry, total lung capacity [TLC] by nitrogen washout or plethysmography, and diffusing capacity of the lung for carbon monoxide corrected for hemoglobin [DLCO corr ]) were obtained. Differences between PFTs obtained immediately after the completion of CSI and 24 or 60 months after the completion of treatment (ACT) were compared using exact Wilcoxon signed-rank tests and repeated-measures models. Results: Between June 24, 2003, and March 1, 2010, 303 eligible patients (spine dose: ≤2345 cGy, 201; >2345 cGy, 102; proton beam, 20) were enrolled, 260 of whom had at least 1 PFT. The median age at diagnosis was 8.9 years (range, 3.1-20.4 years). The median thoracic spinal radiation dose was 23.4 Gy (interquartile range [IQR], 23.4-36.0 Gy). The median cyclophosphamide dose was 16.0 g/m 2 (IQR, 15.7-16.0 g/m 2 ). At 24 and 60 months ACT, DLCO corr was <75% predicted in 23% (27/118) and 25% (21/84) of patients, FEV 1 was <80% predicted in 20% (34/170) and 29% (32/109) of patients, FVC was <80% predicted in 27% (46/172) and 28% (30/108) of patients, and TLC was <75% predicted in 9% (13/138) and 11% (10/92) of patients. DLCO corr was significantly decreased 24 months ACT (median difference [MD] in % predicted, 3.00%; P=.028) and 60 months ACT (MD in % predicted, 6.00%; P=.033) compared with the end of radiation therapy. These significant decreases in DLCO corr were also observed in repeated-measures models (P=.011 and P=.032 at 24 and 60 months ACT, respectively). Conclusions: A significant minority of EBT survivors experience PFT deficits after CSI. Continued monitoring of this cohort

  18. Pulmonary Function After Treatment for Embryonal Brain Tumors on SJMB03 That Included Craniospinal Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Green, Daniel M., E-mail: daniel.green@stjude.org [Department of Epidemiology and Cancer Control, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Merchant, Thomas E. [Department of Radiological Sciences, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Billups, Catherine A. [Department of Biostatistics, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Stokes, Dennis C. [Department of Pediatrics, University of Tennessee School of Medicine, Memphis, Tennessee (United States); Broniscer, Alberto [Department of Oncology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Bartels, Ute [Department of Haematology and Oncology, The Hospital for Sick Children, Toronto, Ontario (Canada); Chintagumpala, Murali [Department of Pediatric Medicine, Texas Children' s Cancer and Hematology Centers, Baylor College of Medicine, Houston, Texas (United States); Hassall, Timothy E. [Department of Haematology and Oncology, Royal Children' s Hospital, Brisbane (Australia); Gururangan, Sridharan [Department of Pediatrics, Duke University Medical Center, Durham, North Carolina (United States); McCowage, Geoffrey B. [Department of Pediatrics, Children' s Hospital at Westmead, Sydney (Australia); Heath, John A. [Children' s Cancer Center, Royal Children' s Hospital Melbourne, Melbourne (Australia); Cohn, Richard J. [Department of Clinical Oncology, Sydney Children' s Hospital, Sydney (Australia); Fisher, Michael J. [Department of Pediatrics, Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States); Srinivasan, Ashok [Department of Bone Marrow Transplantation & Cellular Therapy, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States); Robinson, Giles W.; Gajjar, Amar [Department of Oncology, St. Jude Children' s Research Hospital, Memphis, Tennessee (United States)

    2015-09-01

    Purpose: The treatment of children with embryonal brain tumors (EBT) includes craniospinal irradiation (CSI). There are limited data regarding the effect of CSI on pulmonary function. Methods: Protocol SJMB03 enrolled patients 3 to 21 years of age with EBT. Pulmonary function tests (PFTs) (forced expiratory volume in 1 second [FEV{sub 1}] and forced vital capacity [FVC] by spirometry, total lung capacity [TLC] by nitrogen washout or plethysmography, and diffusing capacity of the lung for carbon monoxide corrected for hemoglobin [DLCO{sub corr}]) were obtained. Differences between PFTs obtained immediately after the completion of CSI and 24 or 60 months after the completion of treatment (ACT) were compared using exact Wilcoxon signed-rank tests and repeated-measures models. Results: Between June 24, 2003, and March 1, 2010, 303 eligible patients (spine dose: ≤2345 cGy, 201; >2345 cGy, 102; proton beam, 20) were enrolled, 260 of whom had at least 1 PFT. The median age at diagnosis was 8.9 years (range, 3.1-20.4 years). The median thoracic spinal radiation dose was 23.4 Gy (interquartile range [IQR], 23.4-36.0 Gy). The median cyclophosphamide dose was 16.0 g/m{sup 2} (IQR, 15.7-16.0 g/m{sup 2}). At 24 and 60 months ACT, DLCO{sub corr} was <75% predicted in 23% (27/118) and 25% (21/84) of patients, FEV{sub 1} was <80% predicted in 20% (34/170) and 29% (32/109) of patients, FVC was <80% predicted in 27% (46/172) and 28% (30/108) of patients, and TLC was <75% predicted in 9% (13/138) and 11% (10/92) of patients. DLCO{sub corr} was significantly decreased 24 months ACT (median difference [MD] in % predicted, 3.00%; P=.028) and 60 months ACT (MD in % predicted, 6.00%; P=.033) compared with the end of radiation therapy. These significant decreases in DLCO{sub corr} were also observed in repeated-measures models (P=.011 and P=.032 at 24 and 60 months ACT, respectively). Conclusions: A significant minority of EBT survivors experience PFT deficits after CSI

  19. Catalyst support structure, catalyst including the structure, reactor including a catalyst, and methods of forming same

    Science.gov (United States)

    Van Norman, Staci A.; Aston, Victoria J.; Weimer, Alan W.

    2017-05-09

    Structures, catalysts, and reactors suitable for use for a variety of applications, including gas-to-liquid and coal-to-liquid processes and methods of forming the structures, catalysts, and reactors are disclosed. The catalyst material can be deposited onto an inner wall of a microtubular reactor and/or onto porous tungsten support structures using atomic layer deposition techniques.

  20. Seroprevalence of Toxoplasma gondii and Trichinella spiralis in North Carolina black bears (Ursus americanus).

    Science.gov (United States)

    Nutter, F B; Levine, J F; Stoskopf, M K; Gamble, H R; Dubey, J P

    1998-10-01

    Serum samples from 143 hunter-killed black bears were collected during the 1996 and 1997 black bear hunting seasons in eastern North Carolina. All samples were tested for antibodies to Toxoplasma gondii by the modified agglutination test. Antibodies to T. gondii were present in 120 of 143 (84%) bears. Females had significantly higher titers than males (Wilcoxon rank sums test, P = 0.045), and titers increased with age (Jonckheere test, P = 0.01). Samples collected during 1996 (n = 79) were tested for antibodies to Trichinella spiralis by enzyme-linked immunosorbent assay. No samples were positive for antibodies to T. spiralis.

  1. The Effect of Early Initiation of Rehabilitation after Lumbar Spinal Fusion

    DEFF Research Database (Denmark)

    Oestergaard, Lisa G; Nielsen, Claus Vinther; Bünger, Cody

    2012-01-01

    examined patients' subsequent rehabilitation. Group-based rehabilitation is both efficient and cost-effective in rehabilitation of lumbar spinal fusion patients.Methods: Patients with degenerative disc diseases undergoing instrumented lumbar spinal fusion were randomly assigned to initiate...... work. Wilcoxon rank sum test was used to compare the groups in terms of differences from baseline to 6 months and 1-year follow-up.Results: According to the ODI, at 1-year follow-up, the 6w-group had a median reduction of -6(-19;4) compared with -20(-30;-7) in the 12w-group (p...

  2. [Clinical impact of social marketing strategy on breast cancer detection].

    Science.gov (United States)

    Quintana-Vidaurri, Adriana Guadalupe; Santana-Chávez, Luis Alejandro; González-Villalobos, Cynthia Guadalupe

    2013-01-01

    to prove the impact of social marketing strategies in breast cancer detection, taking as a parameter the number of mammographies performed. quasi-experimental research, before and after. Sixty-nine physicians in charge of medical consultation and fourteen nurses were studied for a period of seven months, applying social marketing strategies. The total of mammographies were analyzed using Wilcoxon rank-sum test (p marketing proved to be an adequate strategy, which has an impact on the clinical practice of both physicians and nurses.

  3. E-learn Computed Tomographic Angiography

    DEFF Research Database (Denmark)

    Havsteen, Inger; Christensen, Anders; Nielsen, Jens K

    2012-01-01

    BACKGROUND: Computed tomographic angiography (CTA) is widely available in emergency rooms to assess acute stroke patients. To standardize readings and educate new readers, we developed a 3-step e-learning tool based on the test-teach-retest methodology in 2 acute stroke scenarios: vascular...... the teaching segment; the test size was 40% of the teaching segment size. We assessed diagnostic accuracy and readers' confidence. Results were compared using the Wilcoxon rank sum test. RESULTS: Four neurologic consultants and four radiologic residents completed the program. The vascular occlusion teaching...

  4. An exploratory study of human teeth enamel by using Ft-Raman spectroscopy

    International Nuclear Information System (INIS)

    Afishah Alias; Siti Rahayu Mohd Hashim; Mihaly, Judith; Julyannie Wajir; Fauziah Abdul Aziz

    2009-01-01

    Unaffected , affected and heavily affected teeth enamel were studied by using FT-Raman spectroscopy. The 14 permanent teeths enamel surface were measured randomly, resulting in total n = 43 FT-Raman spectra. The results obtained from FT-Raman spectra of heavily affected, affected and unaffected tooths enamel surfaces did not show any significant difference. In this study, Kruskal-Wallis and Wilcoxon rank sum tests were used to compare the intensity between the categories of enamel as well as the surfaces of teeth samples. (author)

  5. Hepatitis C virus infection influences the S-methadone metabolite plasma concentration.

    Directory of Open Access Journals (Sweden)

    Shiow-Ling Wu

    Full Text Available Heroin-dependent patients typically contract hepatitis C virus (HCV at a disproportionately high level due to needle exchange. The liver is the primary target organ of HCV infection and also the main organ responsible for drug metabolism. Methadone maintenance treatment (MMT is a major treatment regimen for opioid dependence. HCV infection may affect methadone metabolism but this has rarely been studied. In our current study, we aimed to test the hypothesis that HCV may influence the methadone dosage and its plasma metabolite concentrations in a MMT cohort from Taiwan.A total of 366 MMT patients were recruited. The levels of plasma hepatitis B virus (HBV, HCV, human immunodeficiency virus (HIV antibodies (Ab, liver aspartate aminotransferase (AST and alanine aminotransferase (ALT, as well as methadone and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP were measured along with the urine morphine concentration and amphetamine screening.Of the 352 subjects in our cohort with HCV test records, 95% were found to be positive for plasma anti-HCV antibody. The liver functional parameters of AST (Wilcoxon Rank-Sum test, P = 0.02 and ALT (Wilcoxon Rank-Sum test, P = 0.04, the plasma methadone concentrations (Wilcoxon Rank-Sum test, P = 0.043 and the R-enantiomer of methadone concentrations (Wilcoxon Rank-Sum test, P = 0.032 were significantly higher in the HCV antibody-positive subjects than in the HCV antibody-negative patients, but not the S-EDDP/methadone dose ratio. The HCV levels correlated with the methadone dose (β= 14.65 and 14.13; P = 0.029 and 0.03 and the S-EDDP/methadone dose ratio (β= -0.41 and -0.40; P = 0.00084 and 0.002 in both univariate and multivariate regression analyses.We conclude that HCV may influence the methadone dose and plasma S-EDDP/methadone dose ratio in MMT patients in this preliminary study.

  6. Hepatitis C Virus Infection Influences the S-Methadone Metabolite Plasma Concentration

    Science.gov (United States)

    Wu, Shiow-Ling; Wang, Sheng-Chang; Tsou, Hsiao-Hui; Kuo, Hsiang-Wei; Ho, Ing-Kang; Liu, Sheng-Wen; Hsu, Ya-Ting; Chang, Yao-Sheng; Liu, Yu-Li

    2013-01-01

    Background and Objectives Heroin-dependent patients typically contract hepatitis C virus (HCV) at a disproportionately high level due to needle exchange. The liver is the primary target organ of HCV infection and also the main organ responsible for drug metabolism. Methadone maintenance treatment (MMT) is a major treatment regimen for opioid dependence. HCV infection may affect methadone metabolism but this has rarely been studied. In our current study, we aimed to test the hypothesis that HCV may influence the methadone dosage and its plasma metabolite concentrations in a MMT cohort from Taiwan. Methods A total of 366 MMT patients were recruited. The levels of plasma hepatitis B virus (HBV), HCV, human immunodeficiency virus (HIV) antibodies (Ab), liver aspartate aminotransferase (AST) and alanine aminotransferase (ALT), as well as methadone and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) were measured along with the urine morphine concentration and amphetamine screening. Results Of the 352 subjects in our cohort with HCV test records, 95% were found to be positive for plasma anti-HCV antibody. The liver functional parameters of AST (Wilcoxon Rank-Sum test, P = 0.02) and ALT (Wilcoxon Rank-Sum test, P = 0.04), the plasma methadone concentrations (Wilcoxon Rank-Sum test, P = 0.043) and the R-enantiomer of methadone concentrations (Wilcoxon Rank-Sum test, P = 0.032) were significantly higher in the HCV antibody-positive subjects than in the HCV antibody-negative patients, but not the S-EDDP/methadone dose ratio. The HCV levels correlated with the methadone dose ( = 14.65 and 14.13; P = 0.029 and 0.03) and the S-EDDP/methadone dose ratio ( = −0.41 and −0.40; P = 0.00084 and 0.002) in both univariate and multivariate regression analyses. Conclusions We conclude that HCV may influence the methadone dose and plasma S-EDDP/methadone dose ratio in MMT patients in this preliminary study. PMID:23935979

  7. Launch Lock Assemblies Including Axial Gap Amplification Devices and Spacecraft Isolation Systems Including the Same

    Science.gov (United States)

    Barber, Tim Daniel (Inventor); Hindle, Timothy (Inventor); Young, Ken (Inventor); Davis, Torey (Inventor)

    2014-01-01

    Embodiments of a launch lock assembly are provided, as are embodiments of a spacecraft isolation system including one or more launch lock assemblies. In one embodiment, the launch lock assembly includes first and second mount pieces, a releasable clamp device, and an axial gap amplification device. The releasable clamp device normally maintains the first and second mount pieces in clamped engagement; and, when actuated, releases the first and second mount pieces from clamped engagement to allow relative axial motion there between. The axial gap amplification device normally residing in a blocking position wherein the gap amplification device obstructs relative axial motion between the first and second mount pieces. The axial gap amplification device moves into a non-blocking position when the first and second mount pieces are released from clamped engagement to increase the range of axial motion between the first and second mount pieces.

  8. Electrolyte solutions including a phosphoranimine compound, and energy storage devices including same

    Science.gov (United States)

    Klaehn, John R.; Dufek, Eric J.; Rollins, Harry W.; Harrup, Mason K.; Gering, Kevin L.

    2017-09-12

    An electrolyte solution comprising at least one phosphoranimine compound and a metal salt. The at least one phosphoranimine compound comprises a compound of the chemical structure ##STR00001## where X is an organosilyl group or a tert-butyl group and each of R.sup.1, R.sup.2, and R.sup.3 is independently selected from the group consisting of an alkyl group, an aryl group, an alkoxy group, or an aryloxy group. An energy storage device including the electrolyte solution is also disclosed.

  9. RETROSPECTIVE STUDY OF METHYLMERCURY AND OTHER METAL(LOID)S IN MADAGASCAR UNPOLISHED RICE (Oryza sativa L.)

    Science.gov (United States)

    Rothenberg, Sarah E.; Mgutshini, Noma L.; Bizimis, Michael; Johnson-Beebout, Sarah E.; Ramanantsoanirina, Alain

    2014-01-01

    The rice ingestion rate in Madagascar is among the highest globally; however studies concerning metal(loid) concentrations in Madagascar rice are lacking. For Madagascar unpolished rice (n=51 landraces), levels of toxic elements (e.g., total mercury, methylmercury, arsenic and cadmium) as well as essential micronutrients (e.g., zinc and selenium) were uniformly low, indicating potentially both positive and negative health effects. Aside from manganese (Wilcoxon rank sum, p<0.01), no significant differences in concentrations for all trace elements were observed between rice with red bran (n=20) and brown bran (n=31) (Wilcoxon rank sum, p=0.06–0.91). Compared to all elements in rice, rubidium (i.e., tracer for phloem transport) was most positively correlated with methylmercury (Pearson's r=0.33, p<0.05) and total mercury (r=0.44, p<0.05), while strontium (i.e., tracer for xylem transport) was least correlated with total mercury and methylmercury (r<0.01 for both), suggesting inorganic mercury and methylmercury were possibly more mobile in phloem compared to xylem. PMID:25463705

  10. Haemophilus influenzae Disease (Including Hib) Diagnosis and Treatment

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search The CDC Haemophilus influenzae Disease (Including Hib) Note: Javascript is disabled or ... Page Diagnosis Treatment Complications Diagnosis Doctors usually diagnose Haemophilus influenzae , including H. influenzae type b or Hib, infection ...

  11. Should Relational Aggression Be Included in DSM-V?

    Science.gov (United States)

    Keenan, Kate; Coyne, Claire; Lahey, Benjamin B.

    2008-01-01

    The study examines whether relational aggression should be included in DSM-V disruptive behavior disorders. The results conclude that some additional information is gathered from assessing relational aggression but not enough to be included in DSM-V.

  12. Partially ionized plasmas including the third symposium on uranium plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Krishnan, M. [ed.

    1976-09-01

    Separate abstracts are included for 28 papers on electrically generated plasmas, fission generated plasmas, nuclear pumped lasers, gaseous fuel reactor research, and applications. Five papers have been previously abstracted and included in ERA.

  13. Dictionary of scientific units including dimensionless numbers and scales

    National Research Council Canada - National Science Library

    Jerrard, H.G; McNeill, D.B

    1992-01-01

    .... The text includes the most recently accepted values of all units. Several disciplines, which have in the past employed few scientific principles and the dictionary has been extended to include examples of these.

  14. SOCR Analyses - an Instructional Java Web-based Statistical Analysis Toolkit.

    Science.gov (United States)

    Chu, Annie; Cui, Jenny; Dinov, Ivo D

    2009-03-01

    The Statistical Online Computational Resource (SOCR) designs web-based tools for educational use in a variety of undergraduate courses (Dinov 2006). Several studies have demonstrated that these resources significantly improve students' motivation and learning experiences (Dinov et al. 2008). SOCR Analyses is a new component that concentrates on data modeling and analysis using parametric and non-parametric techniques supported with graphical model diagnostics. Currently implemented analyses include commonly used models in undergraduate statistics courses like linear models (Simple Linear Regression, Multiple Linear Regression, One-Way and Two-Way ANOVA). In addition, we implemented tests for sample comparisons, such as t-test in the parametric category; and Wilcoxon rank sum test, Kruskal-Wallis test, Friedman's test, in the non-parametric category. SOCR Analyses also include several hypothesis test models, such as Contingency tables, Friedman's test and Fisher's exact test.The code itself is open source (http://socr.googlecode.com/), hoping to contribute to the efforts of the statistical computing community. The code includes functionality for each specific analysis model and it has general utilities that can be applied in various statistical computing tasks. For example, concrete methods with API (Application Programming Interface) have been implemented in statistical summary, least square solutions of general linear models, rank calculations, etc. HTML interfaces, tutorials, source code, activities, and data are freely available via the web (www.SOCR.ucla.edu). Code examples for developers and demos for educators are provided on the SOCR Wiki website.In this article, the pedagogical utilization of the SOCR Analyses is discussed, as well as the underlying design framework. As the SOCR project is on-going and more functions and tools are being added to it, these resources are constantly improved. The reader is strongly encouraged to check the SOCR site for most

  15. "The way I see it": the effect of stigma and depression on self-perceived body image among HIV-positive individuals on treatment in British Columbia, Canada.

    Science.gov (United States)

    Palmer, Alexis K; Duncan, Katrina C; Ayalew, Beza; Zhang, Wendy; Tzemis, Despina; Lima, V; Montaner, Julio S G; Hogg, Robert S

    2011-11-01

    With significant reductions in AIDS-related morbidity and mortality, HIV is increasingly viewed as a chronic condition. However, people on antiretroviral therapy (ART) are experiencing new challenges such as metabolic and morphological body changes, which may affect self-perceived body image. The concept of body image is complex and encompasses an individual's perception of their existential self, physical self and social interpretation of their body by others. The Longitudinal Investigations into Supportive and Ancillary Health Services (LISA) cohort is a prospective study of HIV-positive persons on ART. An interviewer-administered survey collects socio-demographic and health information including body image, stigma, depression, food insecurity, and quality of life (QoL). In bivariate analyses, Chi-squared or Wilcoxon rank sum tests were used to compare individuals reporting positive body image with those reporting negative body image. Multivariate logistic regression was used to examine associations between negative body image and covariates. Of 451 LISA participants, 47% reported negative body image. The adjusted multivariate analysis showed participants who reported high stigma in the presence of depressive symptoms were more likely to have negative body image compared to people reporting low stigma and no depressive symptoms (adjusted odds ratio [AOR]: 2.41, confidence interval [CI]: 1.24-4.68). The estimated probability of a person having positive body image without stigma or depression was 68%. When stigma alone was included, the probability dropped to 59%, and when depression was included alone the probability dropped to 34%. Depressive symptoms and high stigma combined resulted in a probability of reporting positive body image of 27%. Further efforts are needed to address body image among people living with HIV. In order to lessen the impacts of depression on body image, such issues must be addressed in health care settings. Community interventions are

  16. Evaluating College Students' Displayed Alcohol References on Facebook and Twitter.

    Science.gov (United States)

    Moreno, Megan A; Arseniev-Koehler, Alina; Litt, Dana; Christakis, Dimitri

    2016-05-01

    Current trends suggest that adolescents and young adults typically maintain a social media "portfolio" of several sites including Facebook and Twitter, but little is known regarding how an individual chooses to display risk behaviors across these different sites. The purpose of this study was to investigate college students' displayed alcohol references on both Facebook and Twitter. Among a larger sample of college students from two universities, we identified participants who maintained both Facebook and Twitter profiles. Data collection included evaluation of 5 months of participants' Facebook and Twitter posts for alcohol references, number of social connections (i.e., friends or followers), and number of posts. Phone interviews assessed participants' frequency of Facebook and Twitter use and self-reported alcohol use. Analyses included Fisher's exact test, Wilcoxon matched pair sign test, Friedman rank-sum tests, and logistic regression. Of 112 eligible participants, 94 completed the study. Participants were more likely to display alcohol references on Facebook compared with those on Twitter (76% vs. 34%, p = .02). Participants reported more social connections on Facebook versus Twitter (average 801.2 friends vs. 189.4 followers, p Facebook versus Twitter (94.6% vs. 50%, p Facebook and Twitter displayed alcohol references, but mediators differed in each model. College students were more likely to display alcohol references on Facebook compared with those on Twitter. Understanding these patterns and predictors may inform prevention and intervention efforts directed at particular social media sites. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. 75 FR 16513 - B&C Corporation, JR Engineering Division, Including B&C Distribution Center, Including On-Site...

    Science.gov (United States)

    2010-04-01

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-70, 975A] B&C Corporation, JR Engineering Division, Including B&C Distribution Center, Including On-Site Leased Workers From B&C Services... October 2, 2009, applicable to workers of B&C Corporation, JR Engineering Division, including on-site...

  18. Do the Surgical Outcomes of Rectovaginal Fistula Repairs Differ for Obstetric and Nonobstetric Fistulas? A Retrospective Cohort Study.

    Science.gov (United States)

    Karp, Natalie E; Kobernik, Emily K; Berger, Mitchell B; Low, Chelsea M; Fenner, Dee E

    2017-09-15

    Rectovaginal fistulas can occur from both obstetric and nonobstetric (eg, inflammatory bowel disease, iatrogenic, or traumatic) etiologies. Current data on factors contributing to rectovaginal repair success or failure are limited, making adequate patient counseling difficult. Our objective was to compare outcomes of transperineal rectovaginal fistula repair performed in a single referral center on women with obstetric and nonobstetric causes. We performed a retrospective cohort study of women who had a transperineal rectovaginal fistula repair performed by a urogynecologist at the University of Michigan from 2005 to 2015. Data were obtained by chart review and included demographics, medical comorbidities, fistula etiology, history of a prior fistula repair, failure of current repair, time to failure, and operative details. Repair failure was defined as fistula symptoms with presence of recurrent fistula on exam or imaging in the postoperative follow-up period. Comparisons between the obstetric and nonobstetric cohorts were performed using χ, Fisher exact, and Wilcoxon rank sum tests. Relative risks were calculated to identify predictors of failure. Eighty-eight women were included-53 obstetric and 35 nonobstetric fistulas. The overall fistula repair failure rate was 22.7% (n = 20). Median follow-up was 157.0 days (range, 47.5-402.0). Of all the factors, only nonobstetric etiology was significantly associated with an increased risk of repair failure (relative risk, 3.53 [range, 1.50-8.32]; P = 0.004. Nonobstetric rectovaginal fistulas have a nearly 4-fold increased risk of repair failure compared with obstetric fistulas. Our results will help surgeons adequately counsel patients on potential outcomes of surgical repair of obstetric versus nonobstetric rectovaginal fistulas.

  19. Extracorporeal shock-wave lithotripsy: a comparative study of electrohydraulic and electromagnetic units.

    Science.gov (United States)

    Matin, S F; Yost, A; Streem, S B

    2001-12-01

    We determined the results of shock wave lithotripsy with a newer electromagnetic lithotriptor and compared them with those in a contemporary series of cases managed by an electrohydraulic lithotriptor using identical treatment and followup criteria at a single center. Between 1995 and 1999, 356 patients (375 renal units, 483 upper urinary tract stones) meeting study inclusion criteria were treated with an MFL 5000 electrohydraulic shock wave lithotripsy unit (Dornier Medical Systems, Inc., Marietta, Georgia). From 1999 to 2000, 173 patients (175 renal units; 218 upper urinary tract stones) meeting identical study inclusion criteria were treated using an electromagnetic Modulith SLX shock wave lithotripsy unit (Karl Storz Lithotripsy, Atlanta, Georgia). In each group stone-free results were determined by plain abdominal x-ray and renal ultrasound 1 month after lithotripsy and efficiency quotients were developed. Baseline patient and stone characteristics were compared by the Wilcoxon rank sum and Fisher exact tests. All variables significant at p <0.05 were included in subsequent outcome analysis using multivariate logistic regression. Baseline characteristics were equivalent, including patient age, gender, stone number and location, although patients treated with the electrohydraulic unit had a significantly larger median stone burden (103 versus 71 mm.2, p = 0.015). Multivariate regression analysis demonstrated a higher stone-free rate in the electrohydraulic group (77% versus 67%, p = 0.01) but also a higher rate of total adjunctive measures (56% versus 47%, p = 0.04). Consequently the efficiency quotients were comparable for the electrohydraulic and electromagnetic lithotripsy units (0.45 and 0.42, respectively, p = 0.43). Electrohydraulic lithotripsy resulted in a higher stone-free rate at 1 month, although it was associated with a higher rate of auxiliary measures. Ultimately the efficiency quotients were equivalent, implying that these 2 contemporary energy

  20. Adiposity and response to an obesity prevention intervention in Pakistani and Bangladeshi primary school boys and girls: a secondary analysis using the BEACHeS feasibility study.

    Science.gov (United States)

    Cezard, Geneviève; Bansal, Narinder; Bhopal, Raj; Pallan, Miranda; Gill, Paramjit; Barrett, Timothy; Adab, Peymane

    2016-02-09

    As a secondary analysis of the BEACHeS study, we hypothesised there would be sex differences in Pakistani and Bangladeshi school children when examining adiposity and their response to an obesity intervention. The Birmingham healthy Eating and Active lifestyle for CHildren Study (BEACHeS) was designed as a Phase II feasibility study of a complex intervention. 8 primary schools with predominantly South Asian children in Birmingham, UK PARTICIPANTS: 1090 pupils (aged 5-7 years old) from school year 1 and 2 were allocated at school level to receive an intervention. A total of 574 were enrolled in the study with consent. We focused on the 466 children of Pakistani and Bangladeshi origin (50.6% boys). Delivered between 2007 and 2009, the 1-year obesity prevention intervention targeted school and family-based dietary and physical activities. Adiposity measures including skinfold thickness were compared by sex at baseline and follow-up. Gains in adiposity measures were compared between control and intervention arms in boys and in girls. Measures were compared using two-sample t tests and Wilcoxon-Mann-Whitney rank sum tests according to normality distribution. At baseline, girls had larger skinfold measures at all sites compared to boys although body mass index (BMI) was similar (eg, median subscapular skinfold 6.6 mm vs 5.7 mm; pintervention group gained less weight and adiposity compared to respective controls (pintervention group. Our secondary analysis suggests differences in adiposity in Pakistani and Bangladeshi girls and boys and in the effect of the intervention reducing adiposity in girls. These preliminary findings indicate that including sex differences should be examined in future trials. ISRCTN51016370; Post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Women have worse cognitive, functional, and psychiatric outcomes at hospital discharge after cardiac arrest.

    Science.gov (United States)

    Agarwal, Sachin; Presciutti, Alex; Verma, Jayati; Pavol, Marykay A; Anbarasan, Deepti; Brodie, Daniel; Rabbani, Leroy E; Roh, David J; Park, Soojin; Claassen, Jan; Stern, Yaakov

    2018-04-01

    To examine gender differences among cardiac arrest (CA) survivors' cognitive, functional, and psychiatric outcomes at discharge. This is a prospective, observational cohort of 187 CA patients admitted to Columbia University Medical Center, considered for Targeted Temperature Management (TTM), and survived to hospital discharge between September 2015 and July 2017. Patients with sufficient mental status at hospital discharge to engage in the Repeatable Battery for Neuropsychological Status (RBANS), Modified Lawton Physical Self-Maintenance Scale (M-PSMS), Cerebral Performance Category Scale (CPC), Center for Epidemiological Studies Depression Scale (CES-D), and Post-Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) were included. Fisher's exact, Wilcoxon Rank Sum, and regression analysis were utilized. 80 patients (38% women, 44% white, mean age 53 ± 17 years) were included. No significant gender differences were found for age, race, Charlson Comorbidity Index, premorbid CPC or psychiatric diagnoses, arrest related variables, discharge CPC, or PCL-C scores. Women had significantly worse RBANS (64.9 vs 74.8, p = .01), M-PSMS (13.6 vs 10.6, p = .02), and CES-D (22.8 vs 14.3, p = .02) scores. These significant differences were maintained in multivariate models after adjusting for age, initial rhythm, time to return of spontaneous circulation, and TTM. Women have worse cognitive, functional, and psychiatric outcomes at hospital discharge after cardiac arrest than men. Identifying factors contributing to these differences is of great importance in cardiac arrest outcomes research. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Multistate outbreak of Listeriosis linked to turkey deli meat and subsequent changes in US regulatory policy.

    Science.gov (United States)

    Gottlieb, Sami L; Newbern, E Claire; Griffin, Patricia M; Graves, Lewis M; Hoekstra, R Michael; Baker, Nicole L; Hunter, Susan B; Holt, Kristin G; Ramsey, Fred; Head, Marcus; Levine, Priscilla; Johnson, Geraldine; Schoonmaker-Bopp, Dianna; Reddy, Vasudha; Kornstein, Laura; Gerwel, Michal; Nsubuga, Johnson; Edwards, Leslie; Stonecipher, Shelley; Hurd, Sharon; Austin, Deri; Jefferson, Michelle A; Young, Suzanne D; Hise, Kelley; Chernak, Esther D; Sobel, Jeremy

    2006-01-01

    Listeriosis, a life-threatening foodborne illness caused by Listeria monocytogenes, affects approximately 2500 Americans annually. Between July and October 2002, an uncommon strain of L. monocytogenes caused an outbreak of listeriosis in 9 states. We conducted case finding, a case-control study, and traceback and microbiological investigations to determine the extent and source of the outbreak and to propose control measures. Case patients were infected with the outbreak strain of L. monocytogenes between July and November 2002 in 9 states, and control patients were infected with different L. monocytogenes strains. Outcome measures included food exposure associated with outbreak strain infection and source of the implicated food. Fifty-four case patients were identified; 8 died, and 3 pregnant women had fetal deaths. The case-control study included 38 case patients and 53 control patients. Case patients consumed turkey deli meat much more frequently than did control patients (P = .008, by Wilcoxon rank-sum test). In the 4 weeks before illness, 55% of case patients had eaten deli turkey breast more than 1-2 times, compared with 28% of control patients (odds ratio, 4.5; 95% confidence interval, 1.3-17.1). Investigation of turkey deli meat eaten by case patients led to several turkey processing plants. The outbreak strain was found in the environment of 1 processing plant and in turkey products from a second. Together, the processing plants recalled > 30 million pounds of products. Following the outbreak, the US Department of Agriculture's Food Safety and Inspection Service issued new regulations outlining a L. monocytogenes control and testing program for ready-to-eat meat and poultry processing plants. Turkey deli meat was the source of a large multistate outbreak of listeriosis. Investigation of this outbreak helped guide policy changes designed to prevent future L. monocytogenes contamination of ready-to-eat meat and poultry products.

  3. Modality differences between written and spoken story retelling in healthy older adults

    Directory of Open Access Journals (Sweden)

    Jessica Ann Obermeyer

    2015-04-01

    Methods: Ten native English speaking healthy elderly participants between the ages of 50 and 80 were recruited. Exclusionary criteria included neurological disease/injury, history of learning disability, uncorrected hearing or vision impairment, history of drug/alcohol abuse and presence of cognitive decline (based on Cognitive Linguistic Quick Test. Spoken and written discourse was analyzed for micro linguistic measures including total words, percent correct information units (CIUs; Nicholas & Brookshire, 1993 and percent complete utterances (CUs; Edmonds, et al. 2009. CIUs measure relevant and informative words while CUs focus at the sentence level and measure whether a relevant subject and verb and object (if appropriate are present. Results: Analysis was completed using Wilcoxon Rank Sum Test due to small sample size. Preliminary results revealed that healthy elderly people produced significantly more words in spoken retellings than written retellings (p=.000; however, this measure contrasted with %CIUs and %CUs with participants producing significantly higher %CIUs (p=.000 and %CUs (p=.000 in written story retellings than in spoken story retellings. Conclusion: These findings indicate that written retellings, while shorter, contained higher accuracy at both a word (CIU and sentence (CU level. This observation could be related to the ability to revise written text and therefore make it more concise, whereas the nature of speech results in more embellishment and “thinking out loud,” such as comments about the task, associated observations about the story, etc. We plan to run more participants and conduct a main concepts analysis (before conference time to gain more insight into modality differences and implications.

  4. Topical Clonazepam Solution for the Management of Burning Mouth Syndrome: A Retrospective Study.

    Science.gov (United States)

    Kuten-Shorrer, Michal; Treister, Nathaniel S; Stock, Shannon; Kelley, John M; Ji, Yisi D; Woo, Sook-Bin; Lerman, Mark A; Palmason, Stefan; Sonis, Stephen T; Villa, Alessandro

    2017-01-01

    To evaluate and compare the effectiveness of two concentrations of topical clonazepam solution in improving symptoms of burning mouth syndrome (BMS). A retrospective chart review was conducted of patients diagnosed with BMS and managed with topical clonazepam solution between 2008 and 2015. A 0.5-mg/mL solution was prescribed until 2012, when this was changed to a 0.1 mg/mL solution. Patients were instructed to swish with 5 mL for 5 minutes and spit two to four times daily. The efficacies of the two concentrations were compared using patient-reported outcome measures at the first follow-up, including the reported percentage of improvement in burning symptoms and the change in burning severity from baseline ranked on an 11-point numeric rating scale (NRS). Response to treatment was compared between the two concentrations using Wilcoxon rank sum test. A total of 57 subjects were included, 32 in the 0.1-mg/mL cohort and 25 in the 0.5-mg/mL cohort, and evaluated at a median follow-up of 7 weeks. The median overall percentage improvement was 32.5% in the 0.1-mg/mL cohort and 75% in the 0.5-mg/mL cohort. The median reduction in NRS score was 0.5 points in the 0.1-mg/mL cohort and 6 points in the 0.5-mg/mL cohort. The use of either outcome measure revealed that the response to treatment with the 0.5-mg/mL solution was superior to that of the 0.1 mg/mL solution (P clonazepam solution is effective in the management of BMS. Future randomized clinical trials are warranted.

  5. Ceftazidime-Avibactam as Salvage Therapy for Infections Caused by Carbapenem-Resistant Organisms

    Science.gov (United States)

    Temkin, Elizabeth; Torre-Cisneros, Julian; Beovic, Bojana; Benito, Natividad; Giannella, Maddalena; Gilarranz, Raúl; Jeremiah, Cameron; Loeches, Belén; Machuca, Isabel; Jiménez-Martín, María José; Martínez, José Antonio; Mora-Rillo, Marta; Navas, Enrique; Osthoff, Michael; Pozo, Juan Carlos; Ramos Ramos, Juan Carlos; Rodriguez, Marina; Sánchez-García, Miguel; Viale, Pierluigi; Wolff, Michel

    2016-01-01

    ABSTRACT Ceftazidime-avibactam (CAZ-AVI) is a recently approved β-lactam–β-lactamase inhibitor combination with the potential to treat serious infections caused by carbapenem-resistant organisms. Few patients with such infections were included in the CAZ-AVI clinical trials, and clinical experience is lacking. We present a case series of patients with infections caused by carbapenem-resistant Enterobacteriaceae (CRE) or Pseudomonas aeruginosa (CRPa) who were treated with CAZ-AVI salvage therapy on a compassionate-use basis. Physicians who had prescribed CAZ-AVI completed a case report form. We used descriptive statistics to summarize patient characteristics and treatment outcomes. We used the Wilcoxon rank sum test and Fisher's exact test to compare patients by treatment outcome. The sample included 36 patients infected with CRE and two with CRPa. The most common infections were intra-abdominal. Physicians categorized 60.5% of patients as having life-threatening infections. All but two patients received other antibiotics before CAZ-AVI, for a median of 13 days. The median duration of CAZ-AVI treatment was 16 days. Twenty-five patients (65.8%) concurrently received other antibiotics to which their pathogen was nonresistant in vitro. Twenty-eight patients (73.7%, 95% confidence interval [CI], 56.9 to 86.6%) experienced clinical and/or microbiological cure. Five patients (20.8%) with documented microbiological cure died, whereas 10 patients (71.4%) with no documented microbiological cure died (P = 0.01). In three-quarters of cases, CAZ-AVI (alone or combined with other antibiotics) cured infections caused by carbapenem-resistant organisms, 95% of which had failed previous therapy. Microbiological cure was associated with improved survival. CAZ-AVI shows promising clinical results for infections for which treatment options are limited. PMID:27895014

  6. Same-day discharge after laparoscopic hysterectomy.

    Science.gov (United States)

    Perron-Burdick, Misa; Yamamoto, Miya; Zaritsky, Eve

    2011-05-01

    To estimate readmission rates and emergency care use by patients discharged home the same day after laparoscopic hysterectomy. This was a retrospective case series of patients discharged home the same-day after total or supracervical laparoscopic hysterectomy in a managed care setting. Chart reviews were performed for outcomes of interest which included readmission rates, emergency visits, and surgical and demographic characteristics. The two hysterectomy groups were compared using χ² tests for categorical variables and t tests or Wilcoxon rank-sum tests for continuously measured variables. One-thousand fifteen laparoscopic hysterectomies were performed during the 3-year study period. Fifty-two percent (n=527) of the patients were discharged home the same-day; of those, 46% (n=240) had total laparoscopic hysterectomies and 54% (n=287) had supracervical. Cumulative readmission rates were 0.6%, 3.6%, and 4.0% at 48 hours, 3 months, and 12 months, respectively. The most common readmission diagnoses included abdominal incision infection, cuff dehiscence, and vaginal bleeding. Less than 4% of patients presented for emergency care within 48 or 72 hours, most commonly for nausea or vomiting, pain, and urinary retention. Median uterine weight was 155 g, median blood loss was 70 mL, and median surgical time was 150 minutes. There was no difference in readmission rates or emergency visits for the total compared with the supracervical laparoscopic hysterectomy group. Same-day discharge after laparoscopic hysterectomy is associated with low readmission rates and minimal emergency visits in the immediate postoperative period. Same-day discharge may be a safe option for healthy patients undergoing uncomplicated laparoscopic hysterectomy.

  7. SU-F-T-392: Superior Brainstem and Cochlea Sparing with VMAT for Glioblastoma Multiforme

    Energy Technology Data Exchange (ETDEWEB)

    Briere, TM; McAleer, MF; Levy, LB; Yang, JN; Anderson, MD [Cancer Ctr., Houston, TX (United States)

    2016-06-15

    Purpose: Volumetric arc therapy (VMAT) can provide similar target coverage and normal tissue sparing as IMRT but with shorter treatment times. At our institution VMAT was adopted for the treatment glioblastoma multiforme (GBM) after a small number of test plans demonstrated its non-inferiority. In this study, we compare actual clinical treatment plans for a larger cohort of patients treated with either VMAT or IMRT. Methods: 90 GBM patients were included in this study, 45 treated with IMRT and 45 with VMAT. All planning target volumes (PTVs) were prescribed a dose of 50 Gy, with a simultaneous integrated boost to 60 Gy. Most IMRT plans used 5 non-coplanar beams, while most VMAT plans used 2 coplanar beams. Statistical analysis was performed using Fisher’s exact test or the Wilcoxon-Mann-Whitney rank sum test. Included in the analysis were patient and treatment characteristics as well as the doses to the target volumes and organs at risk. Results: Treatment times for the VMAT plans were reduced by 5 minutes compared with IMRT. The PTV coverage was similar, with at least 95% covered for all plans, while the median boost PTV dose differed by 0.1 Gy between the IMRT and VMAT cohorts. The doses to the brain, optic chiasm, optic nerves and eyes were not significantly different. The mean dose to the brainstem, however, was 9.4 Gy less with VMAT (p<0.001). The dose to the ipsilateral and contralateral cochleae were respectively 19.7 and 9.5 Gy less (p<0.001). Conclusion: Comparison of clinical treatment plans for separate IMRT and VMAT cohorts demonstrates that VMAT can save substantial treatment time while providing similar target coverage and superior sparing of the brainstem and cochleae. To our knowledge this is the first study to demonstrate this benefit of VMAT in the management of GBM.

  8. Idiopathic polyhydramnios: persistence across gestation and impact on pregnancy outcomes.

    Science.gov (United States)

    Odibo, Imelda N; Newville, Trista M; Ounpraseuth, Songthip T; Dixon, Mandi; Lutgendorf, Monica A; Foglia, Lisa M; Magann, Everett F

    2016-04-01

    To investigate the likelihood of resolution of idiopathic polyhydramnios in pregnant women and compare outcomes between resolved and persistent cases. One hundred and sixty-three women with idiopathic polyhydramnios who delivered at two medical centers during a 3 year period (January 2012-January 2015) were included in the study. Exclusion criteria included congenital fetal anomalies, maternal diabetes, isoimmunization, fetal infection, placental tumors or anomalies, and multiple gestation. Polyhydramnios was defined as SDP≥8cm or AFI≥24cm. Resolved cases were defined as those with AFI and/or SDP falling and remaining below 24cm and 8cm respectively. Pregnancy outcomes were compared between resolved and persistent cases. Two-sample t-test or Wilcoxon rank-sum test was used for continuous variables while chi-square test or Fisher's exact test was used for categorical measures. Resolution was noted in 61 of 163 (37%) patients. There were no differences in maternal age, gravidity or parity between resolved and persistent cases. Mean gestational age at diagnosis of polyhydramnios and overall mean AFI were significantly lower in the cases that resolved (29.7±4.5 weeks vs 33.4±4.1 weeks, p4000g) and preterm delivery (<37 weeks) in the persistent group (p<0.05). Resolution rate was approximately 37% and more likely in cases diagnosed earlier in pregnancy and with lower mean amniotic fluid volume. Preterm delivery and macrosomia were more common in cases that persisted across gestation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Association of h-index of Editorial Board Members and Impact Factor among Radiology Journals.

    Science.gov (United States)

    Asnafi, Solmaz; Gunderson, Tina; McDonald, Robert J; Kallmes, David F

    2017-02-01

    h-Index has been proposed as a useful bibliometric measure for quantifying research productivity. In this current study, we analyzed h-indices of editorial board members of Radiology journals and tested the hypothesis that editorial board members of Radiology journals with higher impact factors (IF) have higher h-indices. Sixty-two Radiology journals with IF >1 were included. Editorial board members were identified using the journals' websites. Editors' affiliations and research fields of interest were used to distinguish investigators with similar names. Bibliometric indices including number of publications, total citations, citations per publication, and h-index for each editorial board member were obtained using the Web of Science database. Chi-square or Wilcoxon rank-sum tests were used to test for differences in bibliographic measures or demographics between groups. Among the editorial boards of 62 journals, the median [interquartile range] board h-index was 26 [18, 31] and had 36 [17, 56] members. The median journal IF was 2.27 [1.74, 3.31]. We identified a total of 2204 distinct editors; they had a median [interquartile range] h-index of 23 [13, 35], 120 [58, 215] total publications, 1938 [682, 4634] total citations, and an average of 15.7 [9.96, 24.8] citations per publication. The boards of journals with IF above the median had significantly higher h-indices (P = .002), total publications (P = .01), and total and average citations (both any [P = .003, .009] and nonself-citations [P = .001, .002]) than journals below the median. Our data indicate that board members of Radiology journals with higher IF have greater h-indices compared to lower IF journals. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  10. Basketball coaches' utilization of ankle injury prevention strategies.

    Science.gov (United States)

    McGuine, Timothy A; Hetzel, Scott; Pennuto, Anthony; Brooks, Alison

    2013-09-01

    Ankle injuries are the most common high school basketball injury. Little is known regarding the utilization of ankle injury prevention strategies in high school settings. To determine high school basketball coaches' utilization of ankle injury prevention strategies, including prophylactic ankle bracing (PAB) or an ankle injury prevention exercise program (AIEPP). Cross-sectional survey. The survey was distributed to all high school basketball coaches in Wisconsin. Fisher exact and Wilcoxon rank sum tests were used to determine if the injury prevention strategies utilized differed according to school size, sex of the team, years of coaching experience, and the coach's education level. Four hundred eighty (55%) coaches from 299 (74%) high schools completed the survey. Thirty-seven percent of the coaches encouraged or required their players to use PAB. School enrollment of the coaches' teams did not affect their stance on the use of PAB (P = 0.30), neither did the sex of the team (P = 0.16), years coaching (P = 0.09), nor the coach's education (P = 0.49). Fifty percent (n = 242) of the coaches indicated they do not utilize an AIEPP, with no difference based on school enrollment (P = 0.47), team sex (P = 0.41), years coaching (P = 0.78), or the education level (P = 0.44). Barriers to utilization of AIEPP included a lack of time, awareness, and expertise. Coaches preferred an AIEPP that was specific to basketball, combined injury prevention and performance enhancement components, was performed 2 to 3 days per week, and lasted 5 to 15 minutes. Less than half of the coaches encouraged use of PAB, and half did not utilize an AIEPP. Coaches had specific preferences for the type of AIEPP they would implement. Sports medicine providers should promote ankle injury prevention strategies but need to address why prevention strategies may not be utilized in high school basketball settings.

  11. Remote-online case-based learning: A comparison of remote-online and face-to-face, case-based learning - a randomized controlled trial.

    Science.gov (United States)

    Nicklen, Peter; Keating, Jenny L; Paynter, Sophie; Storr, Michael; Maloney, Stephen

    2016-01-01

    Case-based learning (CBL) is an educational approach where students work in small, collaborative groups to solve problems. Computer assisted learning (CAL) is the implementation of computer technology in education. The purpose of this study was to compare the effects of a remote-online CBL (RO-CBL) with traditional face-to-face CBL on learning the outcomes of undergraduate physiotherapy students. Participants were randomized to either the control (face-to-face CBL) or to the CAL intervention (RO-CBL). The entire 3rd year physiotherapy cohort (n = 41) at Monash University, Victoria, Australia, were invited to participate in the randomized controlled trial. Outcomes included a postintervention multiple-choice test evaluating the knowledge gained from the CBL, a self-assessment of learning based on examinable learning objectives and student satisfaction with the CBL. In addition, a focus group was conducted investigating perceptions and responses to the online format. Thirty-eight students (control n = 19, intervention n = 19) participated in two CBL sessions and completed the outcome assessments. CBL median scores for the postintervention multiple-choice test were comparable (Wilcoxon rank sum P = 0.61) (median/10 [range] intervention group: 9 [8-10] control group: 10 [7-10]). Of the 15 examinable learning objectives, eight were significantly in favor of the control group, suggesting a greater perceived depth of learning. Eighty-four percent of students (16/19) disagreed with the statement "I enjoyed the method of CBL delivery." Key themes identified from the focus group included risks associated with the implementation of, challenges of communicating in, and flexibility offered, by web-based programs. RO-CBL appears to provide students with a comparable learning experience to traditional CBL. Procedural and infrastructure factors need to be addressed in future studies to counter student dissatisfaction and decreased perceived depth of learning.

  12. 20 CFR 404.1312 - World War II service included.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false World War II service included. 404.1312... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services World War II Veterans § 404.1312 World War II service included. Your service was in the active service of the United...

  13. 24 CFR 220.822 - Claim computation; items included.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Claim computation; items included. 220.822 Section 220.822 Housing and Urban Development Regulations Relating to Housing and Urban... computation; items included. (a) Assignment of loan. Upon an acceptable assignment of the note and security...

  14. Solar Energy Education. Reader, Part II. Sun story. [Includes glossary

    Energy Technology Data Exchange (ETDEWEB)

    1981-05-01

    Magazine articles which focus on the subject of solar energy are presented. The booklet prepared is the second of a four part series of the Solar Energy Reader. Excerpts from the magazines include the history of solar energy, mythology and tales, and selected poetry on the sun. A glossary of energy related terms is included. (BCS)

  15. 7 CFR 1437.303 - Aquaculture, including ornamental fish.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Aquaculture, including ornamental fish. 1437.303... ASSISTANCE PROGRAM Determining Coverage Using Value § 1437.303 Aquaculture, including ornamental fish. (a) Aquaculture is a value loss crop and is compensable only in accord with restrictions set in this section...

  16. Including Exceptional Students in Your Instrumental Music Program

    Science.gov (United States)

    Mixon, Kevin

    2005-01-01

    This article describes the method and adaptations used by the author in including students with special needs in an instrumental music program. To ensure success in the program, the author shares the method he uses to include exceptional students and enumerates some possible adaptations. There are certainly other methods and modifications that…

  17. 26 CFR 1.1013-1 - Property included in inventory.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Property included in inventory. 1.1013-1 Section... inventory. The basis of property required to be included in inventory is the last inventory value of such property in the hands of the taxpayer. The requirements with respect to the valuation of an inventory are...

  18. A framework for including family health spillovers in economic evaluation

    NARCIS (Netherlands)

    H. Al-Janabi (Hareth); N.J.A. van Exel (Job); W.B.F. Brouwer (Werner); J. Coast (Joanna)

    2016-01-01

    textabstractHealth care interventions may affect the health of patients' family networks. It has been suggested that these health spillovers? should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health

  19. 31 CFR 103.51 - Dollars as including foreign currency.

    Science.gov (United States)

    2010-07-01

    ... RECORDKEEPING AND REPORTING OF CURRENCY AND FOREIGN TRANSACTIONS General Provisions § 103.51 Dollars as including foreign currency. Wherever in this part an amount is stated in dollars, it shall be deemed to mean... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Dollars as including foreign currency...

  20. Electric drive systems including smoothing capacitor cooling devices and systems

    Energy Technology Data Exchange (ETDEWEB)

    Dede, Ercan Mehmet; Zhou, Feng

    2017-02-28

    An electric drive system includes a smoothing capacitor including at least one terminal, a bus bar electrically coupled to the at least one terminal, a thermoelectric device including a first side and a second side positioned opposite the first side, where the first side is thermally coupled to at least one of the at least one terminal and the bus bar, and a cooling element thermally coupled to the second side of the thermoelectric device, where the cooling element dissipates heat from the thermoelectric device.

  1. Elevated salivary IgA, decreased anxiety, and an altered oral microbiota are associated with active participation on an undergraduate athletic team.

    Science.gov (United States)

    Lamb, Ashley L; Hess, Debra E; Edenborn, Sherie; Ubinger, Elizabeth; Carrillo, Andres E; Appasamy, Pierette M

    2017-02-01

    Previous reports indicate that regular, but not excessive, exercise can moderate the response to anxiety and alter the immune response, therefore we hypothesized that college student athletes who were actively participating on an NCAA Division III athletics team ("in-season") would have lower levels of anxiety and higher salivary IgA levels than similar college athletes who were in their "off-season". NCAA Division III athletes participate in athletics at a level of intensity that is more moderate compared to other NCAA divisions. Alterations in the microbiome have been associated with alterations in psychosocial well-being and with exercise. Therefore, we also proposed that the oral microbiota would be different in "in-season" versus "off-season" athletes. In this pilot study, nineteen female students participating on a NCAA Division III athletic team (hockey="in-season"; soccer="off-season") were compared for level of fitness (modified Balke test of VO 2 max), salivary IgA levels by immunoassay, anxiety (using a GAD-7 survey), salivary cortisol levels by immunoassay, and numbers of culturable bacteria by growth of CFU/ml on blood agar, mitis salivarius agar and Staphylococcus 110 agar. The proportion of subjects reporting "severe anxiety" on an anxiety scale (GAD-7) were significantly greater in the "off-season" group compared to the "in-season" group (p=0.047, Chi-squared test). "In-season" athletes had significantly higher salivary IgA/total protein levels than "off-season" athletes (one-sided Student's t-test; p=0.03). Cortisol levels were not significantly different in the two groups. The total culturable bacteria counts were higher among "in-season" athletes (p=0.0455, Wilcoxon Rank Sum test), as measured by CFUs on blood agar plates, an estimate of total culturable bacteria, including pathogenic and non-pathogenic bacteria. In contrast, there was a decrease in the growth of bacteria from the oral cavity of the "in-season" athletes, when the growth of

  2. El sobrepeso es el factor determinante en la presentación de síndrome coronario agudo en adultos jóvenes colombianos Overweight is a determinant factor in the presentation of acute coronary syndrome in colombian young adults

    Directory of Open Access Journals (Sweden)

    Sandra Y Silva

    2008-12-01

    Full Text Available Antecedentes: la obesidad es un factor de riesgo para un primer infarto agudo del miocardio. La enfermedad coronaria prematura genera gran impacto socioeconómico por los años productivos perdidos, lo que hace importante su prevención y tratamiento. Objetivo: evaluar el impacto de la obesidad y otros factores de riesgo convencionales en la presentación de un primer evento coronario agudo en sujetos menores de 50 años. Métodos: estudio transversal que incluyó pacientes con diagnóstico de síndrome coronario agudo que ingresaron a la institución entre febrero de 2002 y febrero de 2007. La población se dividió en: sujetos menores y mayores de 50 años, estos últimos seleccionados de manera aleatoria en relación 1:1. La información demográfica, la historia cardiovascular y los factores de riesgo se identificaron en la historia clínica electrónica de la institución y y se corroboraron por vía telefónica. Se empleó la prueba t de student o Wilcoxon rank-sum, según la distribución de las variables. Se realizó un análisis multivariado para determinar los factores de riesgo independientes. Un valor de p Background: obesity is a risk factor for developing a first myocardial infarct. Premature coronary disease generates a big socioeconomical impact due to productive years loss, which makes important its prevention and treatment. Objective: evaluate the impact of obesity and other conventional risk factors in the presentation of a first acute coronary event in subjects < 50 years. Methods: transversal study that included patients with diagnosis of acute coronary syndrome admitted to the institution between February 2002 and February 2007. The population was divided in subjects younger and older than 50 years, these last ones selected at random in a 1:1 relation. Demographic information, cardiovascular history and risk factors were identified in the institution’s electronic clinical history and were corroborated by telephone. The t

  3. Reduced lung dose and improved inspiration level reproducibility in visually guided DIBH compared to audio coached EIG radiotherapy for breast cancer patients.

    Science.gov (United States)

    Damkjær, Sidsel M S; Aznar, Marianne C; Pedersen, Anders N; Vogelius, Ivan R; Bangsgaard, Jens Peter; Josipovic, Mirjana

    2013-10-01

    Patients with left-sided breast cancer with lymph node involvement have routinely been treated with enhanced inspiration gating (EIG) for a decade at our institution. In a transition from EIG to deep inspiration breath hold (DIBH) we compared the two techniques with focus on target coverage, dose to organs at risk and reproducibility of the inspiration level (IL). Twenty-four patients were computed tomography (CT) scanned with EIG and DIBH. For DIBH we used visual feedback and for EIG audio coaching, both during scan and treatment. Treatment plans for 50 Gy over 25 fractions were calculated. Seventeen of the patients were included in the analysis of reproducibility. They were audio coached for one minute before beam-on in DIBH at nine treatment sessions. These respiration curves were analysed with average maximum IL and standard deviation (SD) for the EIG part of the respiratory signal, and mean IL and SD for the DIBH. Comparison of dosimetric and respiration parameters were performed with the Wilcoxon signed rank-sum test. In DIBH, the ipsilateral lung volume increased further compared to EIG (p < 0.0004, mean increase 11%). This lead to a 9% mean reduction (p = 0.002) of the ipsilateral lung volume receiving 20 Gy (V20 Gy). We found no other significant dosimetric differences between the two methods. The reproducibility of the IL was better with the DIBH method, observed as a significantly smaller SD in most patients (p < 0.04 for 16 of 17 patients). The DIBH method resulted in a significantly larger lung volume and lower ipsilateral lung V20 Gy compared to EIG. The IL for visually guided DIBH was more reproducible than audio-coached EIG. Based on these findings, the DIBH technique is our new breathing adaptation standard for radiotherapy of patients with left-sided breast cancer with lymph node involvement.

  4. A multiplexed analysis approach identifies new association of inflammatory proteins in patients with overactive bladder.

    Science.gov (United States)

    Ma, Emily; Vetter, Joel; Bliss, Laura; Lai, H Henry; Mysorekar, Indira U; Jain, Sanjay

    2016-07-01

    Overactive bladder (OAB) is a common debilitating bladder condition with unknown etiology and limited diagnostic modalities. Here, we explored a novel high-throughput and unbiased multiplex approach with cellular and molecular components in a well-characterized patient cohort to identify biomarkers that could be reliably used to distinguish OAB from controls or provide insights into underlying etiology. As a secondary analysis, we determined whether this method could discriminate between OAB and other chronic bladder conditions. We analyzed plasma samples from healthy volunteers (n = 19) and patients diagnosed with OAB, interstitial cystitis/bladder pain syndrome (IC/BPS), or urinary tract infections (UTI; n = 51) for proinflammatory, chemokine, cytokine, angiogenesis, and vascular injury factors using Meso Scale Discovery (MSD) analysis and urinary cytological analysis. Wilcoxon rank-sum tests were used to perform univariate and multivariate comparisons between patient groups (controls, OAB, IC/BPS, and UTI). Multivariate logistic regression models were fit for each MSD analyte on 1) OAB patients and controls, 2) OAB and IC/BPS patients, and 3) OAB and UTI patients. Age, race, and sex were included as independent variables in all multivariate analysis. Receiver operating characteristic (ROC) curves were generated to determine the diagnostic potential of a given analyte. Our findings demonstrate that five analytes, i.e., interleukin 4, TNF-α, macrophage inflammatory protein-1β, serum amyloid A, and Tie2 can reliably differentiate OAB relative to controls and can be used to distinguish OAB from the other conditions. Together, our pilot study suggests a molecular imbalance in inflammatory proteins may contribute to OAB pathogenesis. Copyright © 2016 the American Physiological Society.

  5. Clinical skills temporal degradation assessment in undergraduate medical education.

    Science.gov (United States)

    Fisher, Joseph; Viscusi, Rebecca; Ratesic, Adam; Johnstone, Cameron; Kelley, Ross; Tegethoff, Angela M; Bates, Jessica; Situ-Lacasse, Elaine H; Adamas-Rappaport, William J; Amini, Richard

    2018-01-01

    Medical students' ability to learn clinical procedures and competently apply these skills is an essential component of medical education. Complex skills with limited opportunity for practice have been shown to degrade without continued refresher training. To our knowledge there is no evidence that objectively evaluates temporal degradation of clinical skills in undergraduate medical education. The purpose of this study was to evaluate temporal retention of clinical skills among third year medical students. This was a cross-sectional study conducted at four separate time intervals in the cadaver laboratory at a public medical school. Forty-five novice third year medical students were evaluated for retention of skills in the following three procedures: pigtail thoracostomy, femoral line placement, and endotracheal intubation. Prior to the start of third-year medical clerkships, medical students participated in a two-hour didactic session designed to teach clinically relevant materials including the procedures. Prior to the start of their respective surgery clerkships, students were asked to perform the same three procedures and were evaluated by trained emergency medicine and surgery faculty for retention rates, using three validated checklists. Students were then reassessed at six week intervals in four separate groups based on the start date of their respective surgical clerkships. We compared the evaluation results between students tested one week after training and those tested at three later dates for statistically significant differences in score distribution using a one-tailed Wilcoxon Mann-Whitney U-test for non-parametric rank-sum analysis. Retention rates were shown to have a statistically significant decline between six and 12 weeks for all three procedural skills. In the instruction of medical students, skill degradation should be considered when teaching complex technical skills. Based on the statistically significant decline in procedural skills noted

  6. Intravoxel incoherent motion (IVIM histogram biomarkers for prediction of neoadjuvant treatment response in breast cancer patients

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    Gene Y. Cho

    Full Text Available Objective: To examine the prognostic capabilities of intravoxel incoherent motion (IVIM metrics and their ability to predict response to neoadjuvant treatment (NAT. Additionally, to observe changes in IVIM metrics between pre- and post-treatment MRI. Methods: This IRB-approved, HIPAA-compliant retrospective study observed 31 breast cancer patients (32 lesions. Patients underwent standard bilateral breast MRI along with diffusion-weighted imaging before and after NAT. Six patients underwent an additional IVIM-MRI scan 12–14 weeks after initial scan and 2 cycles of treatment. In addition to apparent diffusion coefficients (ADC from monoexponential decay, IVIM mean values (tissue diffusivity Dt, perfusion fraction fp, and pseudodiffusivity Dp and histogram metrics were derived using a biexponential model. An additional filter identified voxels of highly vascular tumor tissue (VTT, excluding necrotic or normal tissue. Clinical data include histology of biopsy and clinical response to treatment through RECIST assessment. Comparisons of treatment response were made using Wilcoxon rank-sum tests. Results: Average, kurtosis, and skewness of pseudodiffusion Dp significantly differentiated RECIST responders from nonresponders. ADC and Dt values generally increased (∼70% and VTT% values generally decreased (∼20% post-treatment. Conclusion: Dp metrics showed prognostic capabilities; slow and heterogeneous pseudodiffusion offer poor prognosis. Baseline ADC/Dt parameters were not significant predictors of response. This work suggests that IVIM mean values and heterogeneity metrics may have prognostic value in the setting of breast cancer NAT. Keywords: Breast cancer, Diffusion weighted MRI, Intravoxel incoherent motion, Neoadjuvant treatment, Response evaluation criteria in solid tumors

  7. Development of a Questionnaire for the Assessment of Quality of Life in Korean Children With Allergic Rhinitis

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    Ahn, Young Mee; Kim, Hyung Jin; Lim, Dae Hyun; Son, Byong Kwan; Kang, Hee Suk; Song, Young Eun; Lee, Hee Young

    2014-01-01

    Purpose Korean children have their own unique lifestyle based on their living environment and culture. This study aimed to develop a questionnaire to evaluate the quality of life in Korean children with allergic rhinitis. Methods After a preliminary survey, an initial questionnaire was developed. Questions were modified to be easily understood by young children aged 6 to 7 years. The modified questionnaire was tested on children aged 6 to 12 years old. Item scores, defined as the proportion of children whose answer score was 1 point or higher was multiplied by the average answer score of each question, were used to identify questions that have practical application to the quality of life in Korean children with allergic rhinitis. Differences in answer scores between children with allergic rhinitis and those who were healthy were assessed by a Wilcoxon rank-sum test. The relationship between nasal index scores and quality of life scores was determined by a Spearman rank order test. Results An initial questionnaire was composed of 21 items. We identified 19 questions with item scores above 0.5 in children with allergic rhinitis, many of which were related to nasal symptoms and 10 questions that were different between the allergic rhinitis group and the control group. The final questionnaire included the 10 questions that had both high item scores and a significant difference in the answer scores between the two groups. Conclusions The developed questionnaire is essential and practical for assessing discomfort related to the symptoms felt by Korean children with allergic rhinitis. PMID:25374754

  8. What do faculty feel about teaching in this school? assessment of medical education environment by teachers.

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    Shehnaz, Syed Ilyas; Arifulla, Mohamed; Sreedharan, Jayadevan; Gomathi, Kadayam Guruswami

    2017-01-01

    Faculty members are major stakeholders in curriculum delivery, and positive student learning outcomes can only be expected in an educational environment (EE) conducive to learning. EE experienced by teachers includes all conditions affecting teaching and learning activities. As the EE of teachers indirectly influences the EE of students, assessment of teachers' perceptions of EE can highlight issues affecting student learning. These perceptions can also serve as a valuable tool for identifying faculty development needs. In this study, we have used the Assessment of Medical Education Environment by Teachers (AMEET) inventory as a tool to assess medical teachers' perceptions of the EE. The AMEET inventory was used to assess perceptions regarding various domains of EE by teachers teaching undergraduate students at the College of Medicine, Gulf Medical University, Ajman, United Arab Emirates. Median total, domain, and individual statement scores were compared between groups using Wilcoxon rank-sum test. Teaching-learning activities, learning atmosphere, collaborative atmosphere, and professional self-perceptions were identified as strengths of the EE while time allocated for various teaching-learning activities, preparedness of students, levels of student stress, learning atmosphere in hospital, and support system for stressed faculty members were areas necessitating improvement. The scores of faculty members teaching in basic medical sciences were found to be significantly higher than those in clinical sciences. The EE of this medical college was generally perceived as being positive by faculty although a few areas of concern were highlighted. Strengths and weaknesses of the EE from the teachers' point of view provide important feedback to curriculum planners, which can be used to improve the working environment of the faculty as well as facilitate a better direction and focus to faculty development programs being planned for the future.

  9. Preventing tuberculosis among HIV-infected pregnant women in Lesotho: the case for rolling out active case finding and isoniazid preventive therapy.

    Science.gov (United States)

    Tiam, Appolinaire; Machekano, Rhoderick; Gounder, Celine R; Maama-Maime, Llang B M; Ntene-Sealiete, Keletso; Sahu, Maitreyi; Isavwa, Anthony; Oyebanji, Oyebola; Ahimbisibwe, Allan; Mokone, Majoalane; Barnes, Grace L; Chaisson, Richard E; Guay, Laura; Kassaye, Seble

    2014-09-01

    The Lesotho Ministry of Health issued guidelines on active case finding (ACF) for tuberculosis (TB) and isoniazid preventive therapy (IPT) in April 2011. ACF has been recommended in maternal and child health (MCH) settings globally, however, the feasibility of implementing IPT within MCH in countries with high concurrent HIV and TB epidemics is unknown. The study evaluated the implementation of ACF and IPT guidelines in MCH settings in 2 health facilities in Lesotho. This descriptive prospective study analyzed data collected during routine services. Categorical data and continuous variables were summarized using descriptive statistics. The χ test or Wilcoxon rank-sum test was used to ascertain significant associations between categorical and continuous variables, respectively. Data from 160 HIV-positive and 640 HIV-negative women were reviewed. Within this study population, 99.8% of women were screened for TB, and 11.4% HIV-positive women compared with 2.3% HIV-negative women were reported to have symptoms of TB (P pregnant women, 64.5% women completed a 6-month IPT regimen, 2 (1.6%) died of causes unrelated to IPT/TB, and 31.5% were lost to follow-up. Predictors of IPT initiation among HIV-positive women included gestational age at the first antenatal visit (unadjusted odds ratio, -0.93; 95% confidence interval: -0.88 to 0.98), and receipt of antiretroviral therapy for treatment rather than for prevention of mother-to-child transmission prophylaxis only (odds ratio, 4.59; 95% confidence interval: 1.32 to 15.93). Implementation of ACF and IPT is feasible within the MCH setting. Uptake of IPT during pregnancy among HIV-positive women was high, but with a high rate of loss to follow-up.

  10. Body dysmorphic disorder: prevalence and outcomes in an oculofacial plastic surgery practice.

    Science.gov (United States)

    Woolley, Austin J; Perry, Julian D

    2015-06-01

    To determine the prevalence, associated factors, and surgical outcomes of patients with body dysmorphic disorder in an oculofacial surgery practice. Retrospective cross-sectional analysis of a consecutive case series. Participants consisted of a consecutive series of 728 patients who completed the Dysmorphic Concern Questionnaire in an oculofacial surgery practice at The Cole Eye Institute between November 2013 and June 2014. A questionnaire score ≥9 was used as a positive screen for body dysmorphic disorder. Three control patients scoring ≤8 in the same month were randomly selected for each positive-screening patient. Main outcome measures included number of reoperations, surgical complications, and follow-up visits; preoperative and postoperative pain scores; and the technician word count. Categorical variables were analyzed with Pearson χ(2) tests or Fisher exact tests, while continuous variables were analyzed with Wilcoxon rank sum tests or t tests. A total of 728 patients completed the questionnaire and 50 (6.9%) scored 9 or more. Using a confidence interval of 95%, patients in the positive questionnaire screen group were younger (P = .004), had more eyelid surgeries (P = .007), experienced higher rates of complications after surgery (P = .002), reported higher postoperative pain scores (P = .034), required more reoperations (P = .050), and had a higher technician word count compared to the control group (P = .003). The prevalence of body dysmorphic disorder in an oculofacial surgical setting matches reports from other surgical specialties, and is significantly higher than in the general population. Patients screening positively for body dysmorphic disorder tend to have higher postoperative pain scores and more postoperative complications. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Educational Utility of Advanced 3-Dimensional Virtual Imaging in Evaluating the Anatomical Configuration of the Frontal Recess

    Science.gov (United States)

    Agbetoba, Abib; Luong, Amber; Siow, Jin Keat; Senior, Brent; Callejas, Claudio; Szczygielski, Kornel; Citardi, Martin J.

    2016-01-01

    Introduction Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. Methods Forty-five otorhinolaryngology trainees and 20 medical school students from five academic institutions were enrolled and randomized into 1 of 2 groups. Each subject underwent learning of frontal recess anatomy with both traditional 2D learning methods using a standard DICOM viewing software (RadiAnt Dicom Viewer Version 1.9.16) and 3D learning utilizing a novel preoperative virtual planning software (Scopis Building Blocks), with half learning with the 2D method first and the other half learning with the 3D method first. Four questionnaires that included a total of twenty items were scored for subjects’ self-assessment on knowledge of frontal recess and frontal sinus drainage pathway anatomy following each learned modality. A two-sample Wilcoxon rank-sum test was used in the statistical analysis comparing the 2 groups. Results Most trainees (89%) believed that the virtual 3D planning software significantly improved their understanding of the spatial orientation of the frontal sinus drainage pathway. Conclusion Incorporation of virtual 3D planning surgical software may help augment trainees understanding and spatial orientation of the frontal recess and sinus anatomy. The potential increase in trainee proficiency and comprehension theoretically may translate to improved surgical skill and patient outcomes and in reduced surgical time. PMID:27754596

  12. Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico.

    Science.gov (United States)

    Rodriguez-Noriega, Eduardo; Gonzalez-Diaz, Esteban; Morfin-Otero, Rayo; Gomez-Abundis, Gerardo F; Briseño-Ramirez, Jaime; Perez-Gomez, Hector Raul; Lopez-Gatell, Hugo; Alpuche-Aranda, Celia M; Ramírez, Ernesto; López, Irma; Iguala, Miguel; Bojórquez Chapela, Ietza; Palacios Zavala, Ethel; Hernández, Mauricio; Stuart, Tammy L; Villarino, Margarita Elsa; Widdowson, Marc-Alain; Waterman, Steve; Uyeki, Timothy; Azziz-Baumgartner, Eduardo

    2010-05-14

    Pandemic influenza A (H1N1) virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI) was implemented at Hospital Civil de Guadalajara, Mexico. A medical history, laboratory and radiology results were collected on emergency room (ER) patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1) patients versus test-negative patients were compared by Pearson's Chi(2), Fisher's Exact, and Wilcoxon rank-sum tests. Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15), and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11), and 1324 untreated (median ILI-score = 5). Fourteen (1%) untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score = 19). Of 371 patients tested by RT-PCR, 104 (28%) had pandemic influenza and 42 (11%) had seasonal influenza A detected. Twenty (91%) of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38%) of 61 imaged hospital test-negative patients (pinfluenza presented 6 days after symptom onset, required mechanical ventilation, and died. The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services.

  13. Hospital triage system for adult patients using an influenza-like illness scoring system during the 2009 pandemic--Mexico.

    Directory of Open Access Journals (Sweden)

    Eduardo Rodriguez-Noriega

    2010-05-01

    Full Text Available Pandemic influenza A (H1N1 virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI was implemented at Hospital Civil de Guadalajara, Mexico.A medical history, laboratory and radiology results were collected on emergency room (ER patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1 patients versus test-negative patients were compared by Pearson's Chi(2, Fisher's Exact, and Wilcoxon rank-sum tests.Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15, and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11, and 1324 untreated (median ILI-score = 5. Fourteen (1% untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score = 19. Of 371 patients tested by RT-PCR, 104 (28% had pandemic influenza and 42 (11% had seasonal influenza A detected. Twenty (91% of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38% of 61 imaged hospital test-negative patients (p<0.001. One patient with confirmed pandemic influenza presented 6 days after symptom onset, required mechanical ventilation, and died.The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services.

  14. Impact of surgical approach and patient factors on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scoring in gynecologic surgery.

    Science.gov (United States)

    Wallace, Sumer; Hanson, Kristine T; Dowdy, Sean C; Habermann, Elizabeth B

    2018-01-01

    We sought to compare the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey responses of women who underwent gynecologic surgery at our institution across patient factors and surgical approach. We identified patients with returned HCAHPS surveys following an inpatient laparoscopic surgery or laparotomy in gynecologic surgery from 10/1/2012-9/30/2015. Exclusions included patient agerating methodologies and dichotomized as "high" versus "low." Chi-square, Fisher's exact, and Wilcoxon rank sum tests, and multivariable logistic regression were performed. Of 403 women who met inclusion criteria, 109 (27%) underwent laparoscopic surgery (19% laparoscopic hysterectomy and 8% other laparoscopic procedures) and 294 (73%) laparotomy (28% open hysterectomy and 47% other open procedures). Length of stay (LOS) was longer for laparotomy cases vs. laparoscopy cases (median 2.5days following open hysterectomy and 4days following other open procedures vs 1day following laparoscopic hysterectomy and other laparoscopic procedures, pscores (79% vs 66% laparoscopic hysterectomy, 66% open hysterectomy, and 52% other laparoscopic procedures, p=0.005). After adjustment, non-hysterectomy laparotomy cases were more likely to have a low summary score than non-hysterectomy laparoscopy (OR 3.86, 95% CI 1.71-8.68, p=0.001). This significance did not remain after further adjusting for LOS. In Gynecologic Surgery, patients undergoing laparotomy gave lower hospital ratings compared to laparoscopy. Those with longer LOS reported poorer patient experience, which is the driving variable for lower scores. In the future, it may be necessary to adjust for surgical approach when reporting patient experience scoring. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Molecular Characterization of Staphylococcus aureus Isolates From Children With Periorbital or Orbital Cellulitis.

    Science.gov (United States)

    Foster, Catherine E; Yarotsky, Elizabeth; Mason, Edward O; Kaplan, Sheldon L; Hulten, Kristina G

    2017-06-01

    Periorbital and orbital cellulitis cause significant pediatric morbidity. Here, we define the clinical features of and characterize isolates from children with periorbital or orbital cellulitis caused by Staphylococcus aureus at Texas Children's Hospital in Houston. Patients were identified from a prospective S aureus study database from January 2002 to July 2015. Demographic and clinical data were collected retrospectively. Isolates were genotyped by pulsed-field gel electrophoresis, and Panton-Valentine leukocidin (lukSF-PV [pvl]) genes were detected by quantitative polymerase chain reaction. Data were analyzed with the Fisher exact or Wilcoxon rank-sum test. Eighty-five patients with periorbital (n = 58) or orbital (n = 27) cellulitis were identified. We found 57 (67%) methicillin-resistant S aureus (MRSA) isolates, 72 (85%) pvl-positive (pvl+) isolates, and 66 (78%) USA300 isolates. No differences in clinical characteristics were found when we compared MRSA to methicillin-susceptible (MSSA) infections or USA300 to non-USA300 infections. Patients with orbital cellulitis were hospitalized a median of 12 days (range, 2-28 days) and received antibiotics for 21 days (range, 10-32 days). Twelve (44%) patients with orbital cellulitis received steroids. Steroid treatment did not affect the length of hospitalization or duration of antibiotic treatment. Six (7%) patients with orbital cellulitis were bacteremic. Patients with periorbital cellulitis were hospitalized for a median of 3 days (range, 0-17 days) and received antibiotics for 11 days (range, 7-32 days). According to computed tomography (CT), 19 (70%) patients with orbital cellulitis and 11 (41%) with periorbital cellulitis had sinusitis. The majority of periorbital and orbital S aureus infections at Texas Children's Hospital were caused by MRSA, and no change was observed over time. Empirical antibiotic treatment should include coverage for MRSA. PVL might be an important virulence factor in these presentations

  16. Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Célia Regina Farias de Araújo Lucena

    2013-02-01

    Full Text Available PURPOSE: To compare pain related to intravitreal injection and panretinal photocoagulation in the management of patients with high-risk proliferative diabetic retinopathy. METHODS: Prospective study including patients with high-risk proliferative diabetic retinopathy and no prior laser treatment randomly assigned to receive panretinal photocoagulation (PRP group or panretinal photocoagulation plus intravitreal ranibizumab (PRPplus group. In all patients, panretinal photocoagulation was administered in two sessions (weeks 0 and 2, and intravitreal ranibizumab was administered at the end of the first laser session in the PRPplus group. Retreatment was performed at weeks 16 and 32 if active new vessels were detected at fluorescein angiography. Patients in the PRPplus group received intravitreal ranibizumab and patients in the PRP group received 500-µm additional spots per quadrant of active new vessels. After the end of retreatment, a 100-degree Visual Analog Scale was used for pain score estimation. The patient was asked about the intensity of pain during the whole procedure (retinal photocoagulation session or intravitreal ranibizumab injection. Statistics for pain score comparison were performed using a non-parametric test (Wilcoxon rank sums. RESULTS: Seventeen patients from PRPplus and 14 from PRP group were evaluated for pain scores. There were no significant differences between both groups regarding gender, glycosylated hemoglobin and disease duration. Mean intravitreal injection pain (±SEM was 4.7 ± 2.1 and was significantly lower (p<0.0001 than mean panretinal photocoagulation pain (60.8 ± 7.8. Twelve out of 17 patients from the PRPplus group referred intensity pain score of zero, while the minimal score found in PRP group was found in one patient with 10.5. CONCLUSION: In patients with high-risk proliferative diabetic retinopathy who needed retreatment for persistent new vessels, there was more comfort for the patient when retreatment

  17. Free air on plain film: Do we need a computed tomography too?

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    Carolina V Solis

    2014-01-01

    Full Text Available Context: Standard teaching is that patients with pneumoperitoneum on plain X-ray and clinical signs of abdominal pathology should undergo urgent surgery. It is unknown if abdominal computed tomography (CT provides additional useful information in this scenario. Aims: The aim of this study is to determine whether or not CT scanning after identification of pneumoperitoneum on plain X-ray changes clinical management or outcomes. Settings and Design: Retrospective study carried out over 4 years at a tertiary care academic medical center. All patients in our acute care surgery database with pneumoperitoneum on plain X-ray were included. Patients who underwent subsequent CT scanning (CT group were compared with patients who did not (non-CT group. Statistical Analysis Used: The Wilcoxon rank-sum test, t-test and Fisher′s exact test were used as appropriate to compare the groups. Results: There were 25 patients in the non-CT group and 18 patients in the CT group. There were no differences between the groups at presentation. All patients in the non-CT group underwent surgery, compared with 83% (n = 15 of patients in the CT group (P = 0.066. 16 patients in the non-CT and 11 patients in the CT group presented with peritonitis and all underwent surgery regardless of group. For patients undergoing surgery, there were no differences in outcomes between the groups. After X-ray, patients undergoing CT required 328.0 min to arrive in the operating room compared with 136.0 min in the non-CT group (P = 0.007. Conclusions: In patients with pneumoperitoneum on X-ray and peritonitis on physical exam, CT delays surgery without providing any measurable benefit.

  18. Benefits of a resident-run orientation for new radiology trainees

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    Kara Gaetke-Udager

    2015-06-01

    Full Text Available Incoming radiology residents must rapidly assimilate large amounts of technical, medical, and operational information. This can be overwhelming and contribute to anxiety. Typical introductory curricula focused on radiologic content may not address the concerns of new residents. Two consecutive classes of incoming radiology residents participated in our study. For groups A (n=11 and B (n=11, the existing introductory lectures were given by faculty. For group B, residents hosted sessions for each rotation, including round-table discussions and work area tours, with emphasis on resident roles, personnel, and workflow. With institutional review board exemption, residents were anonymously surveyed before and after the sessions regarding: awareness of responsibilities, familiarity with anatomy, and anxiety regarding each rotation on a 1-4 scale. Free-text comments were collected. Comparison was performed using Wilcoxon rank sum test. Group A reported increased role awareness (P=0.04, greater content familiarity (P<0.05, and decreased anxiety (P=0.02 in one rotation each. There were 3 of 12 rotations in group B that showed significantly increased role awareness (P range <0.01 to 0.01 and decreased anxiety (P range <0.01 to <0.05. In addition, two rotations indicated improved role awareness only (P=0.02 and P=0.04, while there were four rotations reported decreased anxiety only (P range 0.01 to 0.03. Free-text commenters preferred the resident-run portions of the sessions. In conclusion, adding role-oriented introductory sessions to existing lectures for first-year residents decreased anxiety and increased role awareness for all rotations; therefore, it is suggested that anxiety may be better addressed by role-oriented content, and resident-to-resident teaching may have benefits.

  19. If We Don't Ask, Our Patients Might Never Tell: The Impact of the Routine Use of a Patient Values Assessment.

    Science.gov (United States)

    Hoverman, J Russell; Taniguchi, Cynthia; Eagye, Kathryn; Mikan, Sabrina; Kalisiak, Angela; Ash-Lee, Susan; Henschel, Rhonda

    2017-10-01

    Good communication can be associated with better end-of-life outcomes. The US Oncology Network developed and tested a Values Assessment (VA) for facilitating advance care planning (ACP). The results of the first 1,268 patients are reported. The VA consists of 10 questions of the format "How valuable is it to me to…" (eg, "...know that I am not a burden to my family, friends, or helpers?"). Responses were on a four-point scale from unsure to very valuable. VA data on 1,286 patients with metastatic cancer from April 1, 2013, to July 31, 2015, were extracted from the electronic health record, including demographics, diagnosis, stage, chemotherapy, and outcomes (hospice enrollment, place of death). These demographics were compared by using the χ 2 or Fisher's exact test or the Wilcoxon rank sum test for continuous variables. A total of 1,268 patients completed the VA (56.7% were ≥ 65 years of age, 57.8% completed advance directives [ADs]). There were 438 deaths of which 308 had a place of death or a hospice enrollment recorded. Of these, 78% died at home or inpatient hospice; 14.6% died in the hospital. Hospice enrollment with ADs was 76.1% and without, 60.9%. Median length of stay in hospice was 21 days with ADs versus 12.5 days without. Chemotherapy in the last 14 days of life was 8.8% with ADs and 15.5% without. The VA was well accepted by patients. A VA as a routine part of practice is feasible and scalable. It facilitates ACP discussions that lead to ADs. The results suggest that VA and ACP lead to less-aggressive care at the end of life.

  20. [Validity and reproducibility of a food frequency questionnaire to assess lipid and phytochemical intake].

    Science.gov (United States)

    Perovic, Nilda R; Defago, Maria D; Aguinaldo, Anabel; Joekes, Silvia; Actis, Adriana B

    2015-01-01

    epidemiological studies have been related food intake with the incidence of non-transmissible chronic diseases. the purpose of the present study was to analyze the validity and reproducibility of a food frequency questionnaire (FFQ) aimed at assessing lipid and phytochemical intake. FFQ was administered to 45 people of both sexes, aged between 20 and 72 years old and resident in Cordoba, Argentina. The FFQ included 257 questions referring to foods, their consumption frequency and portion size. Regarding consumption of fruit and vegetables, the season was also taken into account. The questionnaire was applied at two different periods (FFQ1 and FFQ2) with a break of six months in between. As a reference, the 24-hour dietary recall was used (24HDR) three times. The mid intake of FFQ1-FFQ2, the 24HDR-FFQ2 median intake, median difference, Mean Absolute Deviation from the median differences (MAD), Wilcoxon signed rank sum test and Spearman rank order correlation coefficients were calculated to analyze the accuracy of the FFQ data. the correlation coefficients for FFQ1-FFQ2 varied from 0.52 for 20:5 n3 eicosapentanoic (EPA) fatty acid to 0.89 for 4:0 butyric fatty acid (p<0.05). For 24HDR-FFQ2, the values ranged from 0.19 for lycopene to 0.93 for EPA fatty acid (p<0.05). the analysis carried out showed an acceptable validity and reproducibility of the FFQ, thus enabling it to be used in research relating the intake of lipids and phytochemicals and the risk of non-transmissible diseases.

  1. Meta-analysis: adjusted indirect comparison of drug-eluting bead transarterial chemoembolization versus {sup 90}Y-radioembolization for hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Ludwig, Johannes M.; Xing, Minzhi [Yale School of Medicine, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Zhang, Di [University of Pittsburgh Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA (United States); Kim, Hyun S. [Yale School of Medicine, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Yale School of Medicine, Yale Cancer Center, New Haven, CT (United States)

    2017-05-15

    To investigate comparative effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) versus Yttrium-90 ({sup 90}Y)-radioembolization for hepatocellular carcinoma (HCC). Studies comparing conventional (c)TACE versus {sup 90}Y-radioembolization or DEB-TACE for HCC treatment were identified using PubMed/Medline, Embase, and Cochrane databases. The adjusted indirect meta-analytic method for effectiveness comparison of DEB-TACE versus {sup 90}Y-radioembolization was used. Wilcoxon rank-sum test was used to compare baseline characteristics. A priori defined sensitivity analysis of stratified study subgroups was performed for primary outcome analyses. Publication bias was tested by Egger's and Begg's tests. Fourteen studies comparing DEB-TACE or {sup 90}Y-radioembolization with cTACE were included. Analysis revealed a 1-year overall survival benefit for DEB-TACE over {sup 90}Y-radioembolization (79 % vs. 54.8 %; OR: 0.57; 95 %CI: 0.355-0.915; p = 0.02; I-squared: 0 %; p > 0.5), but not for the 2-year (61 % vs. 34 %; OR: 0.65; 95%CI: 0.294-1.437; p = 0.29) and 3-year survival (56.4 % vs. 20.9 %; OR: 0.713; 95 % CI: 0.21-2.548; p = 0.62). There was significant heterogeneity in the 2- and 3-year survival analyses. The pooled median overall survival was longer for DEB-TACE (22.6 vs. 14.7 months). There was no significant difference in tumour response rate. DEB-TACE and {sup 90}Y-radioembolization are efficacious treatments for patients suffering from HCC; DEB-TACE demonstrated survival benefit at 1-year compared to {sup 90}Y-radioembolization but direct comparison is warranted for further evaluation. (orig.)

  2. Combined GPS/GLONASS Precise Point Positioning with Fixed GPS Ambiguities

    Science.gov (United States)

    Pan, Lin; Cai, Changsheng; Santerre, Rock; Zhu, Jianjun

    2014-01-01

    Precise point positioning (PPP) technology is mostly implemented with an ambiguity-float solution. Its performance may be further improved by performing ambiguity-fixed resolution. Currently, the PPP integer ambiguity resolutions (IARs) are mainly based on GPS-only measurements. The integration of GPS and GLONASS can speed up the convergence and increase the accuracy of float ambiguity estimates, which contributes to enhancing the success rate and reliability of fixing ambiguities. This paper presents an approach of combined GPS/GLONASS PPP with fixed GPS ambiguities (GGPPP-FGA) in which GPS ambiguities are fixed into integers, while all GLONASS ambiguities are kept as float values. An improved minimum constellation method (MCM) is proposed to enhance the efficiency of GPS ambiguity fixing. Datasets from 20 globally distributed stations on two consecutive days are employed to investigate the performance of the GGPPP-FGA, including the positioning accuracy, convergence time and the time to first fix (TTFF). All datasets are processed for a time span of three hours in three scenarios, i.e., the GPS ambiguity-float solution, the GPS ambiguity-fixed resolution and the GGPPP-FGA resolution. The results indicate that the performance of the GPS ambiguity-fixed resolutions is significantly better than that of the GPS ambiguity-float solutions. In addition, the GGPPP-FGA improves the positioning accuracy by 38%, 25% and 44% and reduces the convergence time by 36%, 36% and 29% in the east, north and up coordinate components over the GPS-only ambiguity-fixed resolutions, respectively. Moreover, the TTFF is reduced by 27% after adding GLONASS observations. Wilcoxon rank sum tests and chi-square two-sample tests are made to examine the significance of the improvement on the positioning accuracy, convergence time and TTFF. PMID:25237901

  3. Factors influencing the parotid function in nasopharyngeal carcinoma treated with parotid-sparing radiotherapy

    International Nuclear Information System (INIS)

    Liu Wenshan; Lee Jongkang; Su Maochang; Lee, S.P.; Chen Ginden; Lee Hongshen; Lee Huei

    2006-01-01

    The background of this study was to evaluate the factors influencing post-irradiation parotid gland function in nasopharyngeal cancer treated with parotid-sparing radiotherapy. This study consisted of 45 patients with nasopharyngeal cancer treated with radiotherapy including 3D conformal radiotherapy, intensity-modulated radiotherapy and high-dose-rate brachytherapy. The mean follow-up time was 37.5 months (range: 15-50 months). Objective parotid gland function was assessed by series sialoscintigraphy pre-irradiation and post-irradiation at 1, 6, 12 and 18 months. Subjective salivary function was recorded by the LENT/SOMA system. Wilcoxon signed-rank test was used to compare the secretion ratio (SR) of parotid gland before and after treatment. Mann-Whitney rank-sum test was used to determine the factors influencing the post-irradiated SR. Chi-square test was used to compare the correlation between subjective grading of xerostomia and objective grading of parotid glands. There was a significant difference between the pre-irradiation and post-irradiation parotid gland's SR at 1 (0.30 versus 0.01, P 0.05) and 18 months (0.30 versus 0.18, P>0.05). There was significant correlation between subjective and objective salivary function (P=0.024) at 12 months after radiotherapy. The factor that impacted the preservation of parotid function was mean dose to the parotid gland >38.0 Gy (P<0.05). Our results demonstrated that parotid function could recover 1 year after treatment with parotid-sparing radiotherapy in patients with nasopharyngeal cancer. The most important factor that influenced parotid function was the mean dose to the parotid gland. (author)

  4. Cerebrospinal fluid Plasmodium falciparum histidine-rich protein-2 in pediatric cerebral malaria.

    Science.gov (United States)

    Thakur, Kiran T; Vareta, Jimmy; Carson, Kathryn A; Kampondeni, Samuel; Potchen, Michael J; Birbeck, Gretchen L; MacCormick, Ian; Taylor, Terrie; Sullivan, David J; Seydel, Karl B

    2018-03-23

    Cerebral malaria (CM) causes a rapidly developing coma, and remains a major contributor to morbidity and mortality in malaria-endemic regions. This study sought to determine the relationship between cerebrospinal fluid (CSF) Plasmodium falciparum histidine rich protein-2 (PfHRP-2) and clinical, laboratory and radiographic features in a cohort of children with retinopathy-positive CM. Patients included in the study were admitted (2009-2013) to the Pediatric Research Ward (Queen Elizabeth Central Hospital, Blantyre, Malawi) meeting World Health Organization criteria for CM with findings of malarial retinopathy. Enzyme-linked immunosorbent assay was used to determine plasma and CSF PfHRP-2 levels. Wilcoxon rank-sum tests and multivariable logistic regression analysis assessed the association of clinical and radiographic characteristics with the primary outcome of death during hospitalization. In this cohort of 94 patients, median age was 44 (interquartile range 29-62) months, 53 (56.4%) patients were male, 6 (7%) were HIV-infected, and 10 (11%) died during hospitalization. Elevated concentrations of plasma lactate (p = 0.005) and CSF PfHRP-2 (p = 0.04) were significantly associated with death. On multivariable analysis, higher PfHRP-2 in the CSF was associated with death (odds ratio 9.00, 95% confidence interval 1.44-56.42) while plasma PfHRP-2 was not (odds ratio 2.05, 95% confidence interval 0.45-9.35). Elevation of CSF, but not plasma PfHRP-2, is associated with death in this paediatric CM cohort. PfHRP-2 egress into the CSF may represent alteration of blood brain barrier permeability related to the sequestration of parasitized erythrocytes in the cerebral microvasculature.

  5. Effects of first radioiodine ablation on functions of salivary glands in patients with differentiated thyroid cancer.

    Science.gov (United States)

    Upadhyaya, Arun; Meng, Zhaowei; Wang, Peng; Zhang, Guizhi; Jia, Qiang; Tan, Jian; Li, Xue; Hu, Tianpeng; Liu, Na; Zhou, Pingping; Wang, Sen; Liu, Xiaoxia; Wang, Huiying; Zhang, Chunmei; Zhao, Fengxiao; Yan, Ziyu

    2017-06-01

    The aim of this study was to evaluate the effects of the first radioactive iodine (I) therapy on functions of salivary glands in patients with differentiated thyroid carcinoma (DTC).There were 36 consented patients with DTC enrolled in this study, who received 3.7 GBq (100mCi) I for ablation after total thyroidectomy. Salivary gland function was assessed using salivary gland scintigraphy in two phases, one 4 hours before and the other 6 months after I therapy (both under thyrotropin stimulation condition). Quantitative parameters including uptake fraction (UF), uptake index (UI), excretion fraction (EF), and excretion ratio (ER) were measured and compared. Blood parameters were also compared. Associations between sex and outcome of the first I therapy as well as individual salivary gland function were measured. Wilcoxon Signed Rank Sum test and χ test were used for statistical analysis.When compared between pre-ablation and post-ablation, UF of bilateral parotid and submandibular glands were significantly increased (all P glands were significantly increased (P salivary gland, which indicated a possible intermediate state after radiation. But salivary glands' secretory function had not changed significantly except for left submandibular gland; we demonstrated that only left submandibular gland showed significantly decreased ER (P salivary gland dysfunctions after the first I therapy. Salivary gland of both males and females could be affected by I therapy.The first I ablative therapy may impair the salivary uptake and secretory function of patients with DTC. There was no association between sex and salivary gland dysfunction.

  6. Effects of tongue cleaning on plaque and salivary mutans streptococci levels: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kochiyil Chacko Jacob

    2015-01-01

    Full Text Available Introduction: Tongue cleaning has been shown to be effective in preventing plaque formation and reducing oral mutans streptococci (MS when used in combination with other oral hygiene procedures. However, correlation between MS counts and plaque levels remains to be demonstrated. Aim: To evaluate the effect of tongue scraping and tongue brushing on salivary MS and plaque levels. Materials and Methods: A triple-blind three arm randomized controlled parallel-group trial was carried out among 54, 12–15-year-old boys in a residential school in Bengaluru city. The study participants were randomly allocated into Group A (toothbrushing and tongue scraping; n = 19, Group B (toothbrushing and tongue brushing; n = 18 and Group C (only toothbrushing; n = 17. The clinical procedure included a collection of saliva and recording of plaque index at baseline, 10th and 21st day. Salivary MS counts were determined using mitis salivarius bacitracin Agar media. ANOVA, Wilcoxon's signed-rank sum test, Mann–Whitney U-test and Spearman's correlation test were performed on log-transformed CFU/mL of MS. Results: The tongue scraping and tongue brushing groups showed statistically significant reductions in salivary MS counts after 10 days (4.76 ± 0.54 (4.79 ± 0.44 and 21 days (4.50 ± 0.44 (4.41 ± 0.57 respectively when performed along with toothbrushing. However, differences between the interventions were not statistically significant. Furthermore, there was no statistically significant reduction in plaque levels after 10 and 21 days. Conclusions: Tongue scraping and tongue brushing were equally effective in reducing salivary MS counts when used in combination with toothbrushing, however, their effect on reducing plaque levels was not significant. Hence, tongue cleaning is recommended as an adjunct to toothbrushing.

  7. Research Professionals' Perspectives, Barriers, and Recommendations Regarding Minority Participation in Clinical Trials.

    Science.gov (United States)

    Kurt, Anita; Semler, Lauren; Meyers, Matthew; Porter, Bernadette G; Jacoby, Jeanne L; Stello, Brian

    2017-12-01

    This study aims to investigate research professionals' perspectives regarding minority participation in clinical trials. A web-based survey of research professionals at US institutions receiving NIH and/or AHRQ funding to conduct clinical research in 2013. Descriptive statistics, mean, standard deviation (SD), and the Wilcoxon rank-sum test were utilized for analysis. Distributed were 13,041 surveys with 967 (7.4%) responses. Overall and race-stratified analyses included 633 and 521 surveys, respectively. A majority agreed that patients' race (mean, 3.4; SD = 1.0) and primary language (mean, 4.0; SD = 0.9) have an effect on enrollment. They had more success in enrolling those whose primary language was the same as their own (mean, 3.8; SD = 1.0), and that a language barrier and time spent arranging for interpreters had prevented them from offering a study to potential candidates (mean, 3.2; SD = 1.2). Non-Caucasian respondents were more likely to agree that "fear of unknown side effects" was a deterrent for minorities (p < 0.01), "minorities are more likely to be unavailable for follow-up phone calls" (p = 0.07), and "the unavailability of translated material discourages non-English speakers from participation" (p = 0.08). They also were more likely to be neutral or agree with being discouraged from enrolling minorities because of the possibility of their withdrawal or being less likely to be available for phone follow-ups and follow-up visits (all p < 0.01). Despite a few subtle racial differences in research professionals' perspectives, a majority expressed no hesitation in enrolling minorities. Patients' race and primary language appeared to influence enrollment. A language barrier appeared to be the strongest barrier for research professionals.

  8. [Intraoperative pain stimuli change somatosensory evoked potentials, but not auditory evoked potentials during isoflurane/nitrous oxide anesthesia].

    Science.gov (United States)

    Rundshagen, I; Kochs, E; Bischoff, P; Schulte am Esch, J

    1997-10-01

    Evoked potentials are used for intraoperative monitoring to assess changes of cerebral function. This prospective randomised study assesses the influence of surgical stimulation on midlatency components of somatosensory (SEPs) and auditory evoked potentials (AEPs) in anaesthetised patients. After approval of the Ethics Committee and written informed consent 36 orthopaedic patients (34 +/- 15 y, 73 +/- 14 kg. 1.71 +/- 0.07 m, ASA I-II) were randomly included in the study. Anaesthesia was induced with 1.5 micrograms/kg fentanyl, 0.3 mg/kg etomidate and 0.1 mg/kg vecuronium. The lungs were intubated and patients normoventilated in steady state anaesthesia with isoflurane (end-tidal 0.6%) and 66% nitrous oxide. 18 patients (group 1) were assigned to the SEP group: median nerve stimulation, recording at Erb, C 6 and the contralateral somatosensory cortex (N20, P25, N35) vs Fz. AEPs were recorded in group 2 (n = 18): binaural stimulation, recording at Cz versus linked mastoid (V, Na, Pa, Nb). Recordings were performed during 30 min before the start of surgery (baseline: BL), at skin incision (SURG1) and at the preparation of the periost (SURG2). Heart rate, mean arterial blood pressure, oxygen saturation, endtidal pCO2 and isoflurane (PetISO) concentrations were registered simultaneously. Data were analysed by one-way analysis of variance. Post hoc comparison were made by Mann-Whitney U-Wilcoxon Rank Sum Test with p beats/min) to SURG2 (76 +/- 12 beats/min). Increases of amplitudes of midlatency SEP amplitudes indicate increased nociceptive signal transmission which is not blunted by isoflurane-nitrous oxide anaesthesia. In contrast, unchanged AEPs indicate adequate levels of the hypnotic components of anaesthesia.

  9. Intravenous urography in the emergency department: when do we need it?

    Science.gov (United States)

    Richards, J R; Christman, C A

    1999-06-01

    Intravenous urography (IVU) is a useful radiographic study in the detection of renal and ureteral calculi. However, it is time consuming, expensive, and exposes the patient to i.v. contrast and radiation. To determine the impact of utilizing IVU less for the detection of renal calculi, criteria for ordering IVU in the emergency department (ED) were evaluated, and patients with high probability of positive IVU were identified. Variables included presence of acute flank pain with haematuria, prior history of renal calculus, degree of haematuria, and uncontrolled pain. We reviewed patients presenting with acute flank and abdominal pain with haematuria from May 1995 to May 1996 at a large urban university hospital. Charts were abstracted for prior history, reason for ordering IVU, time in the ED, laboratory results, IVU result, final diagnosis, and disposition. Data was analysed with Student's t-test, Wilcoxon rank-sum and receiver operating characteristic (ROC) analysis. A total of 302 patients were identified, and 185 underwent IVU during the study period. For patients with prior history of renal calculi 82% had positive IVU (sensitivity 51%, specificity 87%). For patients with both acute flank pain and haematuria, 92% had a positive IVU (sensitivity 93%, specificity 43%), and 19% of patients with abdominal pain of unclear aetiology with haematuria had a positive IVU. All patients with uncontrolled pain had evidence of high-grade obstruction on IVU. Degree of haematuria was not predictive of a positive IVU from ROC curve derivation. IVU is a useful study in the ED but may be overutilized, leading to lengthy patient stays. The combined objective findings of acute flank pain and haematuria are sensitive, and prior history is specific in identifying patients with renal calculi. Degree of haematuria was not useful in predicting renal calculi. By utilizing the criteria of acute flank pain and haematuria as a decision aid, 66% of all IVUs ordered could have been avoided.

  10. Effects of bisphosphonate treatment on DNA methylation in osteonecrosis of the jaw.

    Science.gov (United States)

    Polidoro, Silvia; Broccoletti, Roberto; Campanella, Gianluca; Di Gaetano, Cornelia; Menegatti, Elisa; Scoletta, Matteo; Lerda, Ennio; Matullo, Giuseppe; Vineis, Paolo; Berardi, Daniela; Scully, Crispian; Arduino, Paolo G

    2013-10-09

    Bisphosphonates are used in the treatment of hypocalcaemia, mainly in cancer and osteoporosis. Some patients experience adverse events, such as BP-related osteonecrosis of the jaw (BRONJ). DNA methylation plays a key role in gene regulation in many tissues, but its involvement in bone homeostasis is not well characterized, and no information is available regarding altered methylation in BRONJ. Using the Illumina Infinium HumanMethylation27 BeadChip assay, we performed an epigenome-wide association study in peripheral blood samples from 68 patients treated with nitrogenous BP, including 35 with BRONJ. Analysis of the estimated cumulative BP exposure distribution indicated that the exposure of the case group to BP was slightly higher than that of the control group; more severely affected cases (i.e., with BRONJ in both mandible and maxilla) were significantly more exposed to BP than were those with BRONJ only in the mandible or maxilla (one-sided Wilcoxon rank sum test, p=0.002). Logistic regression analysis confirmed the positive association between cumulative bisphosphonates exposure and risk of BRONJ (OR 1.015 per mg of cumulative exposure, 95% CI 1.004-1.032, p=0.036). Although no statistically significant differences were observed between case and control groups, methylation levels of probes mapping on three genes, ERCC8, LEPREL1 and SDC2, were strongly associated with cumulative BP exposure levels (p<1.31E-007). Enrichment analysis, combining differentially methylated genes with genes involved in the mevalonate pathway, showed that BP treatment can affect the methylation pattern of genes involved in extracellular matrix organization and inflammatory responses, leading to more frequent adverse effects such as BRONJ. Differences in DNA methylation induced by BP treatment could be involved in the pathogenesis of the bone lesion. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. PI-RADS version 2 for prediction of pathological downgrading after radical prostatectomy: a preliminary study in patients with biopsy-proven Gleason Score 7 (3+4) prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Sungmin; Kim, Sang Youn [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Joongyub [Seoul National University College of Medicine, Seoul National University Hospital, Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul (Korea, Republic of); Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine and Kidney Research Institute, Seoul (Korea, Republic of)

    2016-10-15

    To evaluate PI-RADSv2 for predicting pathological downgrading after radical prostatectomy (RP) in patients with biopsy-proven Gleason score (GS) 7(3+4) PC. A total of 105 patients with biopsy-proven GS 7(3+4) PC who underwent multiparametric prostate MRI followed by RP were included. Two radiologists assigned PI-RADSv2 scores for each patient. Preoperative clinicopathological variables and PI-RADSv2 scores were compared between patients with and without downgrading after RP using the Wilcoxon rank sum test or Fisher's exact test. Logistic regression analyses with Firth's bias correction were performed to assess their association with downgrading. Pathological downgrading was identified in ten (9.5 %) patients. Prostate-specific antigen (PSA), PSA density, percentage of cores with GS 7(3+4), and greatest percentage of core length (GPCL) with GS 7(3+4) were significantly lower in patients with downgrading (p = 0.002-0.037). There was no significant difference in age and clinical stage (p = 0.537-0.755). PI-RADSv2 scores were significantly lower in patients with downgrading (3.8 versus 4.4, p = 0.012). At univariate logistic regression analysis, PSA, PSA density, and PI-RADSv2 scores were significant predictors of downgrading (p = 0.003-0.022). Multivariate analysis revealed only PSA density and PI-RADSv2 scores as independent predictors of downgrading (p = 0.014-0.042). The PI-RADSv2 scoring system was an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4) PC. (orig.)

  12. Flipping around the classroom: Accelerated Bachelor of Science in Nursing students' satisfaction and achievement.

    Science.gov (United States)

    El-Banna, Majeda M; Whitlow, Malinda; McNelis, Angela M

    2017-09-01

    The flipped classroom approach is based on shared responsibility for learning by students and teachers, and empowers students to take an active role in the learning process. While utilization of this approach has resulted in higher exam scores compared to traditional approaches in prior studies, the flipped classroom has not included learners in Accelerated Bachelor of Science in Nursing (ABSN) programs. To examine differences on exam scores and satisfaction of teaching between a 3-week flipped and traditional classroom approach. Mixed methods, crossover repeated measures design. Private school of nursing located in the eastern United States. 76 ABSN students. Two separate sections of a Pharmacology course received either 3-weeks of flipped or traditional classroom during Period 1, then switched approaches during Period 2. Two exam scores measuring knowledge and a questionnaire assessing satisfaction of teaching were collected. Focus groups were conducted to learn about students' experience in the flipped classroom. Descriptive statistics, Wilcoxon rank sum test, and stepwise linear mixed model were used to analyze quantitative data. Focus group data were transcribed, coded, and categorized in themes. Students in the flipped classroom achieved significantly higher scores on the first Pharmacology exam than students in the traditional classroom, but there was no significant difference on the second exam. Three themes emerged from focus groups on student perception of integrating the flipped approach: don't fix what isn't broken; treat me as an adult; and remember the work is overwhelming. Both traditional and flipped classroom approaches successfully prepared students for the Pharmacology exams. While results support the use of the flipped approach, judicious use of this instructional pedagogy with dense or difficult content, particularly in accelerated programs, is recommended. Instructors should also provide students with enough information and rationale for using

  13. Sequence robust association test for familial data.

    Science.gov (United States)

    Dai, Wei; Yang, Ming; Wang, Chaolong; Cai, Tianxi

    2017-09-01

    Genome-wide association studies (GWAS) and next generation sequencing studies (NGSS) are often performed in family studies to improve power in identifying genetic variants that are associated with clinical phenotypes. Efficient analysis of genome-wide studies with familial data is challenging due to the difficulty in modeling shared but unmeasured genetic and/or environmental factors that cause dependencies among family members. Existing genetic association testing procedures for family studies largely rely on generalized estimating equations (GEE) or linear mixed-effects (LME) models. These procedures may fail to properly control for type I errors when the imposed model assumptions fail. In this article, we propose the Sequence Robust Association Test (SRAT), a fully rank-based, flexible approach that tests for association between a set of genetic variants and an outcome, while accounting for within-family correlation and adjusting for covariates. Comparing to existing methods, SRAT has the advantages of allowing for unknown correlation structures and weaker assumptions about the outcome distribution. We provide theoretical justifications for SRAT and show that SRAT includes the well-known Wilcoxon rank sum test as a special case. Extensive simulation studies suggest that SRAT provides better protection against type I error rate inflation, and could be much more powerful for settings with skewed outcome distribution than existing methods. For illustration, we also apply SRAT to the familial data from the Framingham Heart Study and Offspring Study to examine the association between an inflammatory marker and a few sets of genetic variants. © 2017, The International Biometric Society.

  14. Comparison of laparoscopic sleeve gastrectomy to laparoscopic Roux-en-Y gastric bypass for morbid obesity in a military institution.

    Science.gov (United States)

    Lim, David M; Taller, Janos; Bertucci, William; Riffenburgh, Robert H; O'Leary, Jack; Wisbach, Gordon

    2014-01-01

    Laparoscopic sleeve gastrectomy (LSG) is gaining acceptance in the bariatric community as a definitive weight loss procedure; however, longitudinal data remain limited. The objective of this study was to compare weight loss results of LSG with laparoscopic Roux-en-Y gastric bypass (LRYGB) up to 5 years postoperatively using anthropometric measurements. Prospectively collected bariatric database at the Naval Medical Center San Diego was retrospectively reviewed from 2005-2011 . Anthropometric factors, including weight and hip circumference were measured during standard yearly follow-up appointments. Surgical outcomes were tested by the Student t test and demographic variables by Fisher's exact and Wilcoxon rank-sum tests. Follow-up was achieved in 147/226 LRYGB versus 130/208 LSG at year 1, 92/195 versus 81/151 at year 2, 64/145 versus 50/100 at year 3, 32/81 versus 18/54 at year 4, and 12/42 versus 14/15 at year 5. The excess weight loss (EWL) for LRYGB versus LSG was 72% versus 64.7% at 1 year (P = .002), 71.3% versus 65.5% at 2 years (P = .113), and 68.3% versus 57.4% at 5 years (P = .252), respectively. Similarly, the body mass index (BMI) decrease was statistically significant at 1 year (P = .001) but not on subsequent annual visits. Mean percent body adiposity index (BAI) decrease was 28.4% for LRYGB versus 26.8% for LSG at 1 year (P = .679) and 21.8% versus 29.8% at 2 years (P = .134), respectively. Weight loss measured in terms of %EWL and decrease in BMI and BAI did not show significance between LRYGB and LSG 2 years after surgery. Our study provides similar long-term weight loss between LSG and LRYGB, and therefore, LSG is a viable option as a definitive bariatric procedure. Published by Elsevier Inc.

  15. Changes in Maternal Plasma Adiponectin from Late Pregnancy to the Postpartum Period According to the Mode of Delivery: Results from a Prospective Cohort in Rio de Janeiro, Brazil.

    Directory of Open Access Journals (Sweden)

    Fernanda Rebelo

    Full Text Available Maternal plasma adiponectin is inversely related to insulin resistance, atherosclerosis and child health. However, little is known about its concentrations in the perinatal period, especially according to mode of delivery. Our aim is to evaluate the association between mode of delivery and changes in maternal plasma adiponectin from 3rd trimester of pregnancy to 30-45 days postpartum.A cohort was recruited in Rio de Janeiro, Brazil, with four waves of follow-up: 5-13th, 22-26th, 30-36th gestational weeks and 30-45 days postpartum. Eligible subjects should be between 20-40 years of age, be free of chronic and infectious diseases and presenting with a singleton pregnancy. The mode of delivery was classified as vaginal (VD or cesarean (CS. Plasma adiponectin concentration (μg/mL was measured using commercial ELISA kits. Statistical analyses included the Wilcoxon rank-sum test and the multiple linear mixed effects model.A total of 159 participated in the study. Median adiponectin concentrations were higher for the VD group (n = 99; 8.25, IQR: 5.85-11.90 than for the CS group (n = 60; 7.34, IQR: 4.36-9.76; p = 0.040 in the postpartum samples but were not different between the two groups in the 3rd trimester. Women who underwent CS had a lower rate of increase in adiponectin concentration from the 3rd trimester to 30-45 days postpartum compared to those who underwent VD (β = -.15, 95% CI: -.28-.02, p = 0.030.The CS procedure was associated with lower maternal circulating concentrations of adiponectin at 30-45 days postpartum, compared to the VD.

  16. Effect of etomidate and propofol induction on hemodynamic and endocrine response in patients undergoing coronary artery bypass grafting/mitral valve and aortic valve replacement surgery on cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Ram Prasad Kaushal

    2015-01-01

    Full Text Available Introduction: The concerns for induction of anaesthesia in patients undergoing cardiac surgery include hemodynamic stability, attenuation of stress response and maintenance of balance between myocardial oxygen demand and supply. Various Intravenous anaesthetic agents like Thiopentone, Etomidate, Propofol, Midazolam, and Ketamine have been used for anesthetizing patients for cardiac surgeries. However, many authors have expressed concerns regarding induction with thiopentone, midazolam and ketamine. Hence, Propofol and Etomidate are preferred for induction in these patients. However, these two drugs have different characteristics. Etomidate is preferred for patients with poor left ventricular (LV function as it provides stable cardiovascular profile. But there are concerns about reduction in adrenal suppression and serum cortisol levels. Propofol, on the other hand may cause a reduction in systemic vascular resistance and subsequent hypotension. Thus, this study was conducted to compare induction with these two agents in cardiac surgeries. Methods: Baseline categorical and continuous variables were compared using Fisher′s exact test and student′s t test respectively. Hemodynamic variables were compared using student′s t test for independent samples. The primary outcome (serum cortisol and blood sugar of the study was compared using Wilcoxon Rank Sum test. The P value less than 0.05 was considered significant. Results: Etomidate provides more stable hemodynamic parameters as compared to Propofol. Propofol causes vasodilation and may result in drop of systematic BP. Etomidate can therefore be safely used for induction in patients with good LV function for CABG/MVR/AVR on CPB without serious cortisol suppression lasting more than twenty-four hours.

  17. Clinical skills temporal degradation assessment in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    JOSEPH FISHER

    2018-01-01

    Full Text Available Introduction: Medical students’ ability to learn clinical procedures and competently apply these skills is an essential component of medical education. Complex skills with limited opportunity for practice have been shown to degrade without continued refresher training. To our knowledge there is no evidence that objectively evaluates temporal degradation of clinical skills in undergraduate medical education. The purpose of this study was to evaluate temporal retention of clinical skills among third year medical students. Methods: This was a cross-sectional study conducted at four separate time intervals in the cadaver laboratory at a public medical school. Forty-five novice third year medical students were evaluated for retention of skills in the following three procedures: pigtail thoracostomy, femoral line placement, and endotracheal intubation. Prior to the start of third-year medical clerkships, medical students participated in a two-hour didactic session designed to teach clinically relevant materials including the procedures. Prior to the start of their respective surgery clerkships, students were asked to perform the same three procedures and were evaluated by trained emergency medicine and surgery faculty for retention rates, using three validated checklists. Students were then reassessed at six week intervals in four separate groups based on the start date of their respective surgical clerkships. We compared the evaluation results between students tested one week after training and those tested at three later dates for statistically significant differences in score distribution using a one-tailed Wilcoxon Mann-Whitney U-test for non-parametric rank-sum analysis. Results: Retention rates were shown to have a statistically significant decline between six and 12 weeks for all three procedural skills. Conclusion: In the instruction of medical students, skill degradation should be considered when teaching complex technical skills. Based on

  18. 22q11.2 Deletion Status and Perioperative Outcomes for Tetralogy of Fallot with Pulmonary Atresia and Multiple Aortopulmonary Collateral Vessels.

    Science.gov (United States)

    Mercer-Rosa, Laura; Elci, Okan U; Pinto, Nelangi M; Tanel, Ronn E; Goldmuntz, Elizabeth

    2018-03-08

    Deletion of 22q11.2 (del22q11) is associated with adverse outcomes in patients with tetralogy of Fallot (TOF). We sought to investigate its contribution to perioperative outcome in patients with a severe form of TOF characterized by pulmonary atresia (PA) or severe pulmonary stenosis (PS) and major aortopulmonary collateral arteries (MAPCAS). We conducted a retrospective review of patients with TOF/MAPCAS who underwent staged surgical reconstruction between 1995 and 2006. Groups were compared according to 22q11.2 deletion status using t-tests or the Wilcoxon Rank sum test. We included 26 subjects, 24 of whom survived the initial operation. Of those, 21 subjects had known deletion status and constitute the group for this analysis [15 with no deletion present (ND) and 6 del22q11 subjects]. There was no difference with respect to occurrence of palliative procedure prior to initial operation, or to timing of closure of the ventricular septal defect (VSD). Other than higher prevalence of prematurity (50%) in the del22q11 group versus no prematurity in the ND, the groups were comparable in terms of pre-operative characteristics. The intra- and post-operative course outcomes (length of cardiopulmonary bypass, use of vasopressors, duration of intensive care and length of hospital stay, tube-feeding) were also comparable. Although the del22q11 had longer mechanical ventilation than the ND, this difference was not significant [68 h (range 4-251) vs. 45 h (range 3-1005), p = 0.81]. In this detailed comparison of a small patient cohort, 22q11.2 deletion syndrome was not associated with adverse perioperative outcomes in patients with TOF, PA, and MAPCAS when compared to those without 22q11.2 deletion syndrome. These results are relevant to prenatal and neonatal pre-operative counseling and planning.

  19. Multi detector computed tomography (MDCT) of the aortic root; ECG-gated verses non-ECG-gated examinations

    International Nuclear Information System (INIS)

    Kristiansen, Joanna; Guenther, Anne; Aalokken, Trond Mogens; Andersen, Rune

    2011-01-01

    Purpose: Motion artifacts may degrade a conventional CT examination of the ascending aorta and hinder accurate diagnosis. We quantitatively compared retrospectively electrocardiographic (ECG) -gated multi detector computed tomography (MDCT) with non-ECG-gated MDCT in order to demonstrate whether or not one of the methods should be preferred. Method: The study included seventeen patients with surgically reconstructed aortic root and reimplanted coronary arteries. All patients had undergone both non-gated MDCT and retrospectively ECG-gated MDCT employing a stringently modulated tube current with single phase image reconstruction. The incidence of motion artifacts in the left main coronary artery (LM), proximal right coronary artery (RCA), and aortic root and ascending aorta were rated using a four point scale. The effective dose for each scan was calculated and normalized to a 15 cm scan length. Statistical analysis of motion artifacts and radiation dose was performed using Wilcoxon matched pairs signed rank sum test. Results: A significant reduction in motion artifacts was found in all three vessels in images from the retrospectively ECG-gated scans (LM: P = 0.005, RCA: P = 0.015, aorta: P = 0.003). The mean normalized effective radiation dose was 3.69 mSv (±1.03) for the non-ECG-gated scans and 16.37 mSv (±2.53) for the ECG-gated scans. Conclusion: Retrospective ECG-gating with single phase reconstruction significantly reduces the incidence of motion artifacts in the aortic root and the proximal portion of the coronary arteries but at the expense of a fourfold increase in radiation dose.

  20. Initial Report of a Prospective Dosimetric and Clinical Feasibility Trial Demonstrates the Potential of Protons to Increase the Therapeutic Ratio in Breast Cancer Compared With Photons.

    Science.gov (United States)

    Bradley, Julie A; Dagan, Roi; Ho, Meng Wei; Rutenberg, Michael; Morris, Christopher G; Li, Zuofeng; Mendenhall, Nancy P

    2016-05-01

    To compare dosimetric endpoints between proton therapy (PT) and conventional radiation and determine the feasibility of PT for regional nodal irradiation (RNI) in women with breast cancer. From 2012 to 2014, 18 women (stage IIA-IIIB) requiring RNI prospectively enrolled on a pilot study. Median age was 51.8 years (range, 42-73 years). The cohort included breast-conserving therapy (BCT) and mastectomy patients and right- and left-sided cancers. Treatment targets and organs at risk were delineated on computed tomography scans, and PT and conventional plans were developed. Toxicity was prospectively recorded using Common Terminology Criteria for Adverse Events version 4.0. A Wilcoxon signed-rank sum test compared the dose-volume parameters. The primary endpoint was a reduction in cardiac V5. Median follow-up was 20 months (range, 2-31 months). For all patients, the PT plan better met the dosimetric goals and was used for treatment. Proton therapy alone was used for 10 patients (9 postmastectomy, 1 after BCT) and combined proton-photon in 8 (6 BCT, 2 postmastectomy with immediate expander reconstruction). Proton therapy improved coverage of level 2 axilla (P=.0005). Adequate coverage of internal mammary nodes was consistently achieved with PT (median D95, 50.3 Gy; range, 46.6-52.1 Gy) but not with conventional radiation therapy (median D95, 48.2 Gy; range, 40.8-55 Gy; P=.0005). Median cardiac V5 was 0.6% with PT and 16.3% with conventional radiation (PRNI after mastectomy or BCT significantly improves cardiac dose, especially for left-sided patients, and lung V5 and V20 in all patients without excessive acute toxicity. Proton therapy simultaneously improves target coverage for the internal mammary nodes and level 2 axilla, which may positively impact long-term survival in breast cancer patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Personal health behaviors and role-modelpan>ing attitudes of physical therapists and physical therapist students: a cross-sectional study.

    Science.gov (United States)

    Black, Beth; Marcoux, Beth C; Stiller, Christine; Qu, Xianggui; Gellish, Ronald

    2012-11-01

    Physical therapists have been encouraged to engage in health promotion practice. Health professionals who engage in healthy behaviors themselves are more apt to recommend those behaviors, and patients are more motivated to change their behaviors when their health care provider is a credible role model. The purpose of this study was to describe the health behaviors and role-modelpan>ing attitudes of physical therapists and physical therapist students. This study was a descriptive cross-sectional survey. A national sample of 405 physical therapists and 329 physical therapist students participated in the survey. Participants' attitudes toward role modeling and behaviors related to physical activity, fruit and vegetable consumption, abstention from smoking, and maintenance of a healthy weight were measured. Wilcoxon rank sum tests were used to examine differences in attitudes and behaviors between physical therapists and physical therapist students. A majority of the participants reported that they engage in regular physical activity (80.8%), eat fruits and vegetables (60.3%), do not smoke (99.4%), and maintain a healthy weight (78.7%). Although there were no differences in behaviors, physical therapist students were more likely to believe that role modeling is a powerful teaching tool, physical therapist professionals should "practice what they preach," physical activity is a desirable behavior, and physical therapist professionals should be role models for nonsmoking and maintaining a healthy weight. Limitations of this study include the potential for response bias and social desirability bias. Physical therapists and physical therapist students engage in health-promoting behaviors at similarly high rates but differ in role-modelpan>ing attitudes.

  2. Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

    Science.gov (United States)

    Brogan, Kit; Lindisfarne, Edward; Akehurst, Harold; Farook, Usama; Shrier, Will; Palmer, Simon

    2016-11-01

    Minimally invasive surgical (MIS) techniques are increasingly being used in foot and ankle surgery but it is important that they are adopted only once they have been shown to be equivalent or superior to open techniques. We believe that the main advantages of MIS are found in the early postoperative period, but in order to adopt it as a technique longer-term studies are required. The aim of this study was to compare the 2-year outcomes of a third-generation MIS distal chevron osteotomy with a comparable traditional open distal chevron osteotomy for mild-moderate hallux valgus. Our null hypothesis was that the 2 techniques would yield equivalent clinical and radiographic results at 2 years. This was a retrospective cohort study. Eighty-one consecutive feet (49 MIS and 32 open distal chevron osteotomies) were followed up for a minimum 24 months (range 24-58). All patients were clinically assessed using the Manchester-Oxford Foot Questionnaire. Radiographic measures included hallux valgus angle, the intermetatarsal angle, hallux interphalangeal angle, metatarsal phalangeal joint angle, distal metatarsal articular angle, tibial sesamoid position, shape of the first metatarsal head, and plantar offset. Statistical analysis was done using Student t test or Wilcoxon rank-sum test for continuous data and Pearson chi-square test for categorical data. Clinical and radiologic postoperative scores in all domains were substantially improved in both groups (P .05). There were no significant differences in complications between the 2 groups ( > .5). The midterm results of this third-generation technique show that it was a safe procedure with good clinical outcomes and comparable to traditional open techniques for symptomatic mild-moderate hallux valgus. Level III, retrospective comparative study. © The Author(s) 2016.

  3. Regulatory T cells in prenatal blood samples: variability with pet exposure and sensitization.

    Science.gov (United States)

    Wegienka, Ganesa; Havstad, Suzanne; Zoratti, Edward M; Woodcroft, Kimberley J; Bobbitt, Kevin R; Ownby, Dennis R; Johnson, Christine Cole

    2009-07-01

    Fetal exposures have come under investigation as risk factors of early life allergic disease. In this study we aimed to examine the relationships between dog or cat exposure and naturally occurring regulatory T cells (Treg cells), thought to play an important role in immune tolerance, in pregnant women. A cross-sectional analysis was conducted among 204 pregnant women who were queried regarding dog and cat exposure. Treg cells (CD4+CD25+Foxp3+ lymphocytes) and allergen-specific IgE were measured in venous blood samples. Atopy was defined as allergen-specific IgE > or =0.35kU/l reactive with common allergens including dust mite, dog, cat, Timothy grass, ragweed, Alternaria alternata, egg white or cockroach. Nonparametric Wilcoxon rank sum tests and linear regression models of log transformed Treg cell levels were used in analyses. Among women sensitized to dog, those who had a dog or cat in the home had lower Treg cell levels compared with those who had no dog or cat. However, among women not sensitized to dog, those with a dog or cat in the home had higher Treg cell levels compared with those who did not. Among women sensitized to cat, those who had a dog or cat in the home had lower Treg cell levels compared with those who had no dog or cat. Gestational age at blood draw did not affect the associations. We conclude that Treg cell levels during pregnancy vary in association with both dog and cat exposure and atopic status.

  4. Local photodynamic therapy delays recurrence of equine periocular squamous cell carcinoma compared to cryotherapy.

    Science.gov (United States)

    Giuliano, Elizabeth A; Johnson, Philip J; Delgado, Cherlene; Pearce, Jacqueline W; Moore, Cecil P

    2014-07-01

    (i) To report the successful treatment of 10 cases of equine periocular squamous cell carcinoma (PSCC) with surgical excision and photodynamic therapy (PDT) using verteporfin. (ii) To evaluate time to first tumor recurrence between PDT-treated horses and horses treated with surgical excision and cryotherapy. A total of 24 equine PSCC cases were included: group 1 (n = 14) had excision and cryotherapy (1993–2003), group 2 (n = 10), excision and local PDT (2006–2010). Evaluated data: signalment, treatment method, tumor location, size, and time to first recurrence. Groups were compared via chi-square test for categorical variables and Wilcoxon rank-sum test for numeric variables. Time to tumor recurrence was examined using Kaplan–Meier product-limit survival analysis. Of 24 cases, nine breeds were affected. Mean age at treatment in years: 14 (range 5–24) in group 1; 11 (range 8–18) in group 2. Median tumor size: 163 mm2 (range 20–625 mm2) in group 1; 195 mm2 (range 45–775 mm2) in group 2. Signalment, tumor laterality, and size were not significantly different between groups. Time to recurrence was significantly different between groups (Logrank test, P = 0.0006). In group 1, 11/14 horses had tumor regrowth with median time to recurrence in months: 10 (range 1–44). In group 2 (minimum follow-up of 25 months; range 25–50), no horse demonstrated tumor recurrence after one treatment with excision and PDT. This represents the first report of local PDT using verteporfin for treatment of equine PSCC. Following surgery, the likelihood of tumor recurrence was significantly reduced with local PDT compared with cryotherapy. © 2013 American College of Veterinary Ophthalmologists.

  5. Relationship between disclosure of same-sex sexual activity to providers, HIV diagnosis and sexual health services for men who have sex with men in Vancouver, Canada.

    Science.gov (United States)

    Ng, Brian E; Moore, David; Michelow, Warren; Hogg, Robert; Gustafson, Réka; Robert, Wayne; Kanters, Steve; Thumath, Meaghan; McGuire, Marissa; Gilbert, Mark

    2014-04-16

    Men who have sex with men (MSM) report challenges to accessing appropriate health care. We sought to understand the relationship between disclosure of same-sex sexual activity to a health care practitioner (HCP), sexual behaviour and measures of sexual health care. Participants recruited through community venues and events completed a questionnaire and provided a blood sample. This analysis includes only individuals with self-reported HIV negative or unknown serostatus. We compared participants who had disclosed having same-sex partners with those who had not using chi-square, Wilcoxon Rank Sum and Fisher's exact tests and used logistic regression to examine those variables associated with receiving an HIV test. Participants who had disclosed were more likely to have a higher level of education (p<0.001) and higher income (p<0.001), and to define themselves as "gay" or "queer" (p<0.001). Those who had not disclosed were less likely to report having risky sex (p=0.023) and to have been tested for HIV in the previous two years (adjusted odds ratio 0.23, 95% confidence interval: 0.16-0.34). There was no difference in undiagnosed HIV infection (3.9% versus 2.6%, p=0.34). Individuals who had disclosed were also more likely to have been tested for gonorrhea and syphilis, and more likely to have ever been vaccinated against hepatitis A and hepatitis B (p<0.001 for all). While generally reporting lower risk behaviour, MSM who did not disclose same-sex sexual activity to their HCP did have undiagnosed HIV infections and were less likely to have been tested or vaccinated. Strategies to improve access to appropriate sexual health care for MSM are needed.

  6. Transformation of a Pediatric Primary Care Waiting Room: Creating a Bridge to Community Resources.

    Science.gov (United States)

    Henize, Adrienne W; Beck, Andrew F; Klein, Melissa D; Morehous, John; Kahn, Robert S

    2018-03-10

    Introduction Children and families living in poverty frequently encounter social risks that significantly affect their health and well-being. Physicians' near universal access to at-risk children and their parents presents opportunities to address social risks, but time constraints frequently interfere. We sought to redesign our waiting room to create a clinic-to-community bridge and evaluate the impact of that redesign on family-centered outcomes. Methods We conducted a pre-post study of a waiting room redesign at a large, academic pediatric primary care center. Design experts sought input about an optimal waiting room from families, community partners and medical providers. Family caregivers were surveyed before and after redesign regarding perceived availability of help with social needs and access to community resources, and hospitality and feelings of stress. Pre-post differences were assessed using the Chi square or Wilcoxon rank sum test. Results The key redesign concepts that emerged included linkages to community organizations, a welcoming environment, and positive distractions for children. A total of 313 caregiver surveys were completed (pre-160; post-153). Compared to pre-redesign, caregivers surveyed post-redesign were significantly more likely to perceive the waiting room as a place to obtain help connecting to community resources and find information about clinical and educational resources (both p < 0.05). Families were also significantly more likely to report the waiting room as more welcoming and relaxing, with sufficient privacy and space (all p < 0.05). Discussion Waiting rooms, typically a place of wasted time and space, can be redesigned to enhance families' engagement and connection to community resources.

  7. Dual-axis rotational coronary angiography: a new technique for detecting graft coronary vasculopathy in pediatric heart transplant recipients.

    Science.gov (United States)

    Gudausky, Todd M; Pelech, Andrew N; Stendahl, Gail; Tillman, Kathryn; Mattice, Judy; Berger, Stuart; Zangwill, Steven

    2013-03-01

    Annual surveillance coronary angiograpyhy to screen for graft coronary vasculopathy is routine practice after orthotopic heart transplantation. Traditionally, this is performed with direct coronary angiography using static single-plane or biplane angiography. Recently, technological advances have made it possible to perform dual-axis rotational coronary angiography (RA). This technique differs from standard static single-plane or biplane angiography in that a single detector is preprogrammed to swing through a complex 80° arc during a single injection. It has the advantage of providing a perspective of the vessels from a full arc of images rather than from one or two static images per contrast injection. The current study evaluated two coronary angiography techniques used consecutively at a single center to evaluate pediatric heart transplant recipients for graft coronary vasculopathy. A total of 23 patients underwent routine coronary angiography using both biplane static coronary angiography (BiP) and RA techniques at the Children's Hospital of Wisconsin from February 2009 to September 2010. Demographic and procedure data were collected from each procedure and analyzed for significance utilizing a Wilcoxon rank sum test. No significant demographic or procedural differences between the BiP and the RA procedures were noted. Specific measures of radiation dose including fluoroscopy time and dose area product were similar among the imaging techniques. The findings show that RA can be performed safely and reproducibly in pediatric heart transplant recipients. Compared with standard BiP, RA does not increase radiation exposure or contrast use and in our experience has provided superior angiographic imaging for the evaluation of graft coronary vasculopathy.

  8. Effects of implant length and 3D bone-to-implant contact on initial stabilities of dental implant: a microcomputed tomography study.

    Science.gov (United States)

    Hsu, Jui-Ting; Wu, Aaron Yu-Jen; Fuh, Lih-Jyh; Huang, Heng-Li

    2017-11-21

    The influences of potential bone-to-implant contact (BIC) area (pBICA), BIC area (BICA), and three dimensional (3D) BIC percentage (3D BIC%; defined as BICA divided by pBICA) in relation to the implant length on initial implant stability were studied. Correlations between these parameters were also evaluated. Implants with lengths of 8.5, 10, 11.5, and 13 mm were placed in artificial bone specimens to measure three indexes of the initial implant stability: insertion torque value (ITV), Periotest value (PTV), and implant stability quotient (ISQ). The implants and bone specimens were also scanned by microcomputed tomography, and the obtained images were imported into Mimics software to reconstruct the 3D models and calculate the parameters of 3D bone-to-implant contact including pBICA, BICA, and 3D BIC%. The Kruskal-Wallis test, Wilcoxon rank-sum test with Bonferroni adjustment, and Spearman correlations were applied for statistical and correlation analyses. The implant length affected ITV more than PTV and ISQ, and significantly affected pBICA, BICA, and 3D BIC%. A longer implant increased pBICA and BICA but decreased 3D BIC%. The Spearman coefficients were high (>0.78) for the correlations between the three 3D BIC parameters and the three indexes of the initial implant stability. pBICA, BICA, and 3D BIC% are useful when deciding on treatment plans related to various implant lengths, since these 3D BIC parameters are predictive of the initial implant stability.

  9. Rapeseed oil, olive oil, plant sterols, and cholesterol metabolism: an ileostomy study.

    Science.gov (United States)

    Ellegård, L; Andersson, H; Bosaeus, I

    2005-12-01

    To study whether olive oil and rapeseed oil have different effects on cholesterol metabolism. Short-term experimental study, with controlled diets. Outpatients at a metabolic-ward kitchen. A total of nine volunteers with conventional ileostomies. Two 3-day diet periods; controlled diet including 75 g of rapeseed oil or olive oil. Cholesterol absorption, ileal excretion of cholesterol, and bile acids. Serum levels of cholesterol and bile acid metabolites. Differences between diets evaluated with Wilcoxon's signed rank sum test. Rapeseed oil diet contained 326 mg more plant sterols than the olive oil diet. Rapeseed oil tended to decrease cholesterol absorption by 11% (P = 0.050), and increased excretion of cholesterol, bile acids, and their sum as sterols by 9% (P = 0.021), 32% (P = 0.038), and 51% (P = 0.011) compared to olive oil. A serum marker for bile acid synthesis (7alpha-hydroxy-4-cholesten-3-one) increased by 28% (P = 0.038) within 10 h of consumption, and serum cholesterol levels decreased by 7% (P = 0.024), whereas a serum marker for cholesterol synthesis (lathosterol) as well as serum levels of plant sterols remained unchanged. Rapeseed oil and olive oil have different effects on cholesterol metabolism. Rapeseed oil, tends to decrease cholesterol absorption, increases excretion of cholesterol and bile acids, increases serum marker of bile acid synthesis, and decreases serum levels of cholesterol compared to olive oil. This could in part be explained by different concentrations of natural plant sterols. Supported by the Göteborg Medical Society, the Swedish Medical Society, the Swedish Board for Agricultural Research (SJFR) grant 50.0444/98 and by University of Göteborg.

  10. A prospective crossover trial of botulinum toxin chemodenervation versus injection augmentation for essential voice tremor.

    Science.gov (United States)

    Estes, Christine; Sadoughi, Babak; Coleman, Rachel; Sarva, Harini; Mauer, Elizabeth; Sulica, Lucian

    2018-02-01

    Botulinum toxin chemodenervation (BTX) is used to treat essential voice tremor (EVT), but results are not uniformly satisfactory. This study sought to assess the comparative utility of injection augmentation (IA) for EVT. Prospective crossover treatment study. Patients with EVT underwent BTX. After washout patients underwent IA. Multidimensional assessment carried out prior to and 30 days after each treatment included 1) videostroboscopy graded by the Vocal Tremor Scoring System (VTSS), 2) acoustic and aerodynamic assessment (cepstral peak prominence, cepstral spectral index of dysphonia, cepstral peak prominence fundamental frequency, airflow, peak air pressure and intensity, maximum phonation time, and amplitude/frequency of tremor), 3) audio-perceptual assessment via Consensus Audio-Perceptual Evaluation of Voice (CAPE-V), and 4) patient self-assessment via Voice Handicap Index-10 (VHI-10) and Percent of Normal Function (PNF) scale. Findings were analyzed via paired t tests and Wilcoxon rank sum tests. Seven patients (five female and two male; mean age 67 years old; range, 46-82 years old) participated. VTSS grading showed divergent outcomes for certain individual sites of tremor, but without significant differences. Airflow increased following BTX and decreased following IA, and VHI-10 scores indicated slight improvement post-BTX (26.29-23.57), and decline post-IA (25.86-29.86), although differences were not significant. Only changes in audio-perceptual ratings of loudness achieved significance, which decreased with BTX and increased with IA. Five patients chose to resume BTX; two elected long-term IA. No findings supported patient preferences. IA demonstrated no advantage over BTX in the treatment of EVT. 2b. Laryngoscope, 128:437-446, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  11. Effect of clenbuterol on tracheal mucociliary transport in horses undergoing simulated long-distance transportation.

    Science.gov (United States)

    Norton, J L; Jackson, K; Chen, J W; Boston, R; Nolen-Walston, R D

    2013-01-01

    Pneumonia is observed in horses after long-distance transportation in association with confinement of head position leading to reduction in tracheal mucociliary clearance rate (TMCR). Clenbuterol, a beta-2 agonist shown to increase TMCR in the horse, will ameliorate the effects of a fixed elevated head position on large airway contamination and inflammation in a model of long-distance transportation model. Six adult horses. A cross-over designed prospective study. Horses were maintained with a fixed elevated head position for 48 hours to simulate long-distance transport, and treated with clenbuterol (0.8 μg/kg PO q12h) or a placebo starting 12 hours before simulated transportation. TMCR was measured using a charcoal clearance technique. Data were collected at baseline and 48 hours, and included TMCR, tracheal wash cytology and quantitative culture, rectal temperature, CBC, fibrinogen, and serum TNFα, IL-10, and IL-2 levels. There was a 18-21 day washout between study arms, and data were analyzed using regression analysis and Wilcoxon rank-sum tests. Tracheal mucociliary clearance rate was significantly decreased after transportation in both treatment (P = .002) and placebo (P = .03) groups. There was a significant effect of treatment on TMCR, with the treatment group showing half the reduction in TMCR compared with the placebo group (P = .002). Other significant differences between before- and after-transportation samples occurred for serum fibrinogen, peripheral eosinophil count, quantitative culture, tracheal bacteria, and degenerate neutrophils, though no treatment effect was found. Treatment with clenbuterol modestly attenuates the deleterious effects of this long-distance transportation model on tracheal mucociliary clearance. Copyright © 2013 by the American College of Veterinary Internal Medicine.

  12. Social media presence of otolaryngology journals: The past, present, and future.

    Science.gov (United States)

    Wong, Kevin; Piraquive, Jacquelyn; Levi, Jessica R

    2018-02-01

    Evaluate the use of Twitter by otolaryngology journals and determine the relationship between social media altmetrics and measures of academic impact. Cross-sectional analysis. Twitter profiles from the top 50 otolaryngology journals per 2016 SCImago Journal & Country Rank (SJR) were included. Twitter activity for each profile was calculated using Twitonomy analytics and Riffle software. Social media influence was measured using Klout scores. Annual SJR rank and H-Index scores between 2008 and 2016 were recorded for each journal. Associations between social media influence and academic indices were assessed using Wilcoxon rank sum test, Spearman's rank order test, and Pearson correlation coefficients (α = .05). Average SJR was 0.86 ± 0.3 and H-Index was 50.9 ± 24. Eighteen journals had Twitter profiles. Journals with social media accounts had significantly higher SJR (P = .03) and H-Index (P = .01) scores compared to those without. The average Klout score of Twitter profiles was 32.5 ± 13. There was a significant association between a journal's Klout score and SJR rank (P = .004). Older Twitter profiles had higher Klout scores (P = .04). There was a direct relationship between a journal's total Twitter followers and H-Index score (P = .009), and a direct relationship between tweets and academic influence (P = .03 and .01 for SJR and H-Index, respectively). Social media is often underutilized and remains an untapped resource by many journals to increase readership and disseminate research. Journals with social media profiles had significantly higher academic metrics, and among journals with profiles, increased online activity was a predictor for academic influence. Future studies are warranted to elucidate causal relationships. NA. Laryngoscope, 128:363-368, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Health-related quality of life and social support among women treated for abortion complications in western Uganda.

    Science.gov (United States)

    Lubinga, Solomon J; Levine, Gillian A; Jenny, Alisa M; Ngonzi, Joseph; Mukasa-Kivunike, Peter; Stergachis, Andy; Babigumira, Joseph B

    2013-07-15

    While the impact of abortion complications on clinical outcomes and healthcare costs has been reported, we found no reports of their impact on Health-Related Quality of Life (HRQoL), nor the role of social support in moderating such outcomes. In this study, we performed an assessment of the relationship between abortion complications, HRQoL and social support among women in Uganda. We interviewed women who were discharged after treatment for abortion complications and, as a comparison, women visiting a regional referral hospital for routine obstetric care. We administered the EuroQol instrument and the Social Support Questionnaire Short-Form, and collected demographic and socioeconomic data. We performed descriptive analyses using t-tests, Wilcoxon rank-sum tests and chi-square tests, and multivariable linear regressions with interaction effects to examine the associations between abortion complications, EQ-5D utility scores and social support. Our study included 139 women (70 with abortion complications, and 69 receiving routine obstetric care). In four out of the 5 dimensions of the EQ-5D, a larger proportion of women with abortion complications reported "some or severe" problems than women receiving routine obstetric care (self-care: 42% v 24%, p=0.033; usual activities: 49% v 16%, pabortion complications had a 0.12 (95% CI: 0.07, 0.18, p effect of social support showed that a one-unit higher average number of people providing social support was associated with larger mean difference in EQ-5D utility score when comparing the two groups, while a one unit higher average satisfaction score with social support was associated with smaller mean differences in EQ-5D utility score. Our study suggests that abortion complications are associated with diminished HRQoL and the magnitude of the association depends on social support. However, the mediating role of social support in a setting of social and legal proscriptions to induced abortion is complex.

  14. Comparison of Cartesian and radial acquisition on short-tau inversion recovery (STIR sequences in breast MRI

    Directory of Open Access Journals (Sweden)

    Domiziana Santucci

    Full Text Available Abstract Objective: The purpose of this study was to compare two short-tau inversion recovery (STIR sequences, Cartesian and radial (BLADE acquisitions, for breast magnetic resonance imaging (MRI examinations. Materials and Methods: Ninety-six women underwent 1.5 T breast MRI exam (48 Cartesian and 48 BLADE. Qualitative analysis including image artifacts, image quality, fat-suppression, chest-wall depiction, lesion detection, lymph node depiction and overall impression were evaluated by three blinded readers. Signal to noise ratios (SNRs were calculated. Cronbach's alpha test was used to assess inter-observer agreement. Subanalyses of image quality, chest-wall depiction and overall impression in 15 patients with implants and image quality in 31 patients with clips were correlated using Pearson test. Wilcoxon rank sum test and t-test were performed. Results: Motion artifacts were present in 100% and in 0% of the Cartesian and the BLADE exams, respectively. Chemical-shift artifacts were present in 8% of the Cartesian exams. Flow artifacts were more frequent on BLADE. BLADE sequence was statistically superior to Cartesian for all qualitative features (p < 0.05 except for fat-suppression (p = 0.054. In the subanalysis, BLADE was superior for implants and clips (p < 0.05. SNR was statistically greater for BLADE (48.35 vs. 16.17. Cronbach ranged from 0.502 to 0.813. Conclusion: BLADE appears to be superior to Cartesian acquisition of STIR imaging as measured by improved image quality, fewer artifacts, and improved chest wall and lymph node depiction.

  15. Hearing loss in enlarged vestibular aqueduct and incomplete partition type II.

    Science.gov (United States)

    Ahadizadeh, Emily; Ascha, Mustafa; Manzoor, Nauman; Gupta, Amit; Semaan, Maroun; Megerian, Cliff; Otteson, Todd

    The purpose of this work is to identify the role of incomplete partition type II on hearing loss among patients with enlarged vestibular aqueduct (EVA). EVA is a common congenital inner ear malformation among children with hearing loss, where vestibular aqueduct morphology in this population has been shown to correlate to hearing loss. However, the impact of incomplete partition between cochlear turns on hearing loss has not been, despite meaningful implications for EVA pathophysiology. A retrospective review of radiology reports for patients who had computed tomography (CT) scans with diagnoses of hearing loss at a tertiary medical center between January 2000 and June 2016 were screened for EVA. CT scans of the internal auditory canal (IAC) for those patients with EVA were examined for evidence of incomplete partition type II (IP-II), measurements of midpoint width and operculum width a second time, and patients meeting Cincinnati criteria for EVA selected for analysis. Statistical analysis including chi-square, Wilcoxon rank-sum, and t-tests were used to identify differences in outcomes and clinical predictors, as appropriate for the distribution of the data. Linear mixed models of hearing test results for all available tests were constructed, both univariable and adjusting for vestibular aqueduct morphometric features, with ear-specific intercepts and slopes over time. There were no statistically significant differences in any hearing test results or vestibular aqueduct midpoint and operculum widths. Linear mixed models, both univariable and those adjusting for midpoint and operculum widths, did not indicate a statistically significant effect of incomplete partition type II on hearing test results. Hearing loss due to enlarged vestibular aqueduct does not appear to be affected by the presence of incomplete partition type II. Our results suggest that the pathophysiological processes underlying hearing loss in enlarged vestibular aqueduct may not be a result of

  16. Effects of first radioiodine ablation on functions of salivary glands in patients with differentiated thyroid cancer

    Science.gov (United States)

    Upadhyaya, Arun; Meng, Zhaowei; Wang, Peng; Zhang, Guizhi; Jia, Qiang; Tan, Jian; Li, Xue; Hu, Tianpeng; Liu, Na; Zhou, Pingping; Wang, Sen; Liu, Xiaoxia; Wang, Huiying; Zhang, Chunmei; Zhao, Fengxiao; Yan, Ziyu

    2017-01-01

    Abstract The aim of this study was to evaluate the effects of the first radioactive iodine (131I) therapy on functions of salivary glands in patients with differentiated thyroid carcinoma (DTC). There were 36 consented patients with DTC enrolled in this study, who received 3.7 GBq (100mCi) 131I for ablation after total thyroidectomy. Salivary gland function was assessed using salivary gland scintigraphy in two phases, one 4 hours before and the other 6 months after 131I therapy (both under thyrotropin stimulation condition). Quantitative parameters including uptake fraction (UF), uptake index (UI), excretion fraction (EF), and excretion ratio (ER) were measured and compared. Blood parameters were also compared. Associations between sex and outcome of the first 131I therapy as well as individual salivary gland function were measured. Wilcoxon Signed Rank Sum test and χ2 test were used for statistical analysis. When compared between pre-ablation and post-ablation, UF of bilateral parotid and submandibular glands were significantly increased (all P submandibular glands were significantly increased (P gland, which indicated a possible intermediate state after radiation. But salivary glands’ secretory function had not changed significantly except for left submandibular gland; we demonstrated that only left submandibular gland showed significantly decreased ER (P gland dysfunctions after the first 131I therapy. Salivary gland of both males and females could be affected by 131I therapy. The first 131I ablative therapy may impair the salivary uptake and secretory function of patients with DTC. There was no association between sex and salivary gland dysfunction. PMID:28640094

  17. A Longitudinal Study of Functional Outcomes in Patients with Limb Salvage Surgery for Soft Tissue Sarcoma

    Directory of Open Access Journals (Sweden)

    Eunsun Oh

    2018-01-01

    Full Text Available Background. Many studies have reported on the surgical outcomes of soft tissue sarcoma. However, there was no longitudinal cohort study. Because time is the most valuable factor for functional recovery, adjusting time value was the key for finding the causal relationship between other risk factors and postoperative function. Therefore, existing cross-sectional studies can neither fully explain the causal relationship between the risk factors and the functional score nor predict functional recovery. The aim of this study was to determine important predictive factors that affect postoperative functional outcomes and longitudinal changes in functional outcomes in patients who had undergone limb-sparing surgery (LSS for soft tissue sarcoma (STS. Methods. Between January 2008 and December 2014, we retrospectively enrolled 150 patients who had undergone LSS for STS and had been assessed for postoperative functional outcomes with questionnaires. To evaluate functional outcomes, we used the Musculoskeletal Tumor Society (MSTS score and Toronto Extremity Salvage Score (TESS. Multivariate generalized estimating equation (GEE analysis was used to identify the predictive factors, including size, stage, and anatomic location of tumor, bone resection, flap reconstruction, age, and time after surgery. Each continuous variable such as age and time after surgery was explored for statistically significant cutoff points using the Wilcoxon rank sum test. Results. Functional scores significantly improved until the second year after surgery and plateaued for the rest of the 5-year period. Age p<0.0001, bone resection p=0.0004, and time after surgery p<0.0001 were identified as significant predictive factors. The functional score was significantly higher in patients younger than 47 years old. Conclusions. Functional outcomes can improve until the second year after surgery. Patients who were older than 47 and underwent bone resection may have poor final functional

  18. Whole-body MR neurography: Prospective feasibility study in polyneuropathy and Charcot-Marie-Tooth disease.

    Science.gov (United States)

    Chhabra, Avneesh; Carrino, John A; Farahani, Sahar J; Thawait, Gaurav K; Sumner, Charlotte J; Wadhwa, Vibhor; Chaudhary, Vinay; Lloyd, Thomas E

    2016-12-01

    To evaluate the feasibility of whole-body magnetic resonance neurography (WBMRN) in polyneuropathy for technical feasibility, distribution of nerve abnormalities, and differentiation. Twenty WBMRN examinations were performed on a 3T scanner over 2 years. Patient demographics including history of hereditary and acquired neuropathy were recorded. The images were evaluated by two independent readers with nerve imaging experience for quality. The nerve signal and size alterations were measured in the brachial plexus, lumbosacral plexus, and femoral and sciatic nerves; diffusion tensor imaging parameters (fractional anisotropy [FA] and apparent diffusion coefficient [ADC]) were determined in plexuses, and tractography was performed. Nonparametric Wilcoxon rank sum test, receiver operating characteristic (ROC) analysis, and intraclass correlation coefficients (ICCs) were obtained. Excellent image quality was obtained for the majority of lumbosacral (LS) plexus (18/20) and 50% of brachial plexus (10/20) regions. Qualitatively among cases, the nerve hyperintensity and/or thickening involved the brachial plexus (11/11), LS plexus (7/11), and both plexuses (7/11), with most nerve thickenings observed in Charcot-Marie-Tooth disease type 1. The nerve signal intensity alterations were significantly different for both brachial (P < 0.05) and LS (P < 0.05) plexuses in cases versus controls. The femoral and sciatic nerve size alterations were different (P < 0.05), while signal intensity differences were not significant (P = 0.1-0.97). Transverse dimensions of C8 (4 mm), L5 (6.2 mm) and S1 (5.1 mm) nerve roots, and sciatic nerves (10.2 mm) were the most accurate diagnostic performance measures in distinguishing cases from controls. WBMRN is feasible for use in the clinical practice for the identification and potential characterization of polyneuropathy. J. Magn. Reson. Imaging 2016;44:1513-1521. © 2016 International Society for Magnetic Resonance in Medicine.

  19. Initiation devices, initiation systems including initiation devices and related methods

    Energy Technology Data Exchange (ETDEWEB)

    Daniels, Michael A.; Condit, Reston A.; Rasmussen, Nikki; Wallace, Ronald S.

    2018-04-10

    Initiation devices may include at least one substrate, an initiation element positioned on a first side of the at least one substrate, and a spark gap electrically coupled to the initiation element and positioned on a second side of the at least one substrate. Initiation devices may include a plurality of substrates where at least one substrate of the plurality of substrates is electrically connected to at least one adjacent substrate of the plurality of substrates with at least one via extending through the at least one substrate. Initiation systems may include such initiation devices. Methods of igniting energetic materials include passing a current through a spark gap formed on at least one substrate of the initiation device, passing the current through at least one via formed through the at least one substrate, and passing the current through an explosive bridge wire of the initiation device.

  20. Stages of Plasma Cell Neoplasms (Including Multiple Myeloma)

    Science.gov (United States)

    ... Treatment Health Professional Plasma Cell Neoplasms Treatment Research Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Patient Version General Information About Plasma Cell Neoplasms Go to Health Professional Version Key ...

  1. Including estimates of the future in today's financial statements

    OpenAIRE

    Mary Barth

    2006-01-01

    This paper explains why the question is how, not if, today's financial statements should include estimates of the future. Including such estimates is not new, but their use is increasing. This increase results primarily because standard setters believe asset and liability measures that reflect current economic conditions and up-to-date expectations of the future will result in more useful information for making economic decisions, which is the objective of financial reporting. This is why sta...

  2. Internet addiction neuroscientific approaches and therapeutical implications including smartphone addiction

    CERN Document Server

    Reuter, Martin

    2017-01-01

    The second edition of this successful book provides further and in-depth insight into theoretical models dealing with Internet addiction, as well as includes new therapeutical approaches. The editors also broach the emerging topic of smartphone addiction. This book combines a scholarly introduction with state-of-the-art research in the characterization of Internet addiction. It is intended for a broad audience including scientists, students and practitioners. The first part of the book contains an introduction to Internet addiction and their pathogenesis. The second part of the book is dedicated to an in-depth review of neuroscientific findings which cover studies using a variety of biological techniques including brain imaging and molecular genetics. The third part of the book focuses on therapeutic interventions for Internet addiction. The fourth part of the present book is an extension to the first edition and deals with a new emerging potential disorder related to Internet addiction – smartphone addicti...

  3. Ceramic substrate including thin film multilayer surface conductor

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, Joseph Ambrose; Peterson, Kenneth A.

    2017-05-09

    A ceramic substrate comprises a plurality of ceramic sheets, a plurality of inner conductive layers, a plurality of vias, and an upper conductive layer. The ceramic sheets are stacked one on top of another and include a top ceramic sheet. The inner conductive layers include electrically conductive material that forms electrically conductive features on an upper surface of each ceramic sheet excluding the top ceramic sheet. The vias are formed in each of the ceramic sheets with each via being filled with electrically conductive material. The upper conductive layer includes electrically conductive material that forms electrically conductive features on an upper surface of the top ceramic sheet. The upper conductive layer is constructed from a stack of four sublayers. A first sublayer is formed from titanium. A second sublayer is formed from copper. A third sublayer is formed from platinum. A fourth sublayer is formed from gold.

  4. Including information technology project management in the nursing informatics curriculum.

    Science.gov (United States)

    Sockolow, Paulina; Bowles, Kathryn H

    2008-01-01

    Project management is a critical skill for nurse informaticists who are in prominent roles developing and implementing clinical information systems. It should be included in the nursing informatics curriculum, as evidenced by its inclusion in informatics competencies and surveys of important skills for informaticists. The University of Pennsylvania School of Nursing includes project management in two of the four courses in the master's level informatics minor. Course content includes the phases of the project management process; the iterative unified process methodology; and related systems analysis and project management skills. During the introductory course, students learn about the project plan, requirements development, project feasibility, and executive summary documents. In the capstone course, students apply the system development life cycle and project management skills during precepted informatics projects. During this in situ experience, students learn, the preceptors benefit, and the institution better prepares its students for the real world.

  5. Classical mechanics including an introduction to the theory of elasticity

    CERN Document Server

    Hentschke, Reinhard

    2017-01-01

    This textbook teaches classical mechanics as one of the foundations of physics. It describes the mechanical stability and motion in physical systems ranging from the molecular to the galactic scale. Aside from the standard topics of mechanics in the physics curriculum, this book includes an introduction to the theory of elasticity and its use in selected modern engineering applications, e.g. dynamic mechanical analysis of viscoelastic materials. The text also covers many aspects of numerical mechanics, ranging from the solution of ordinary differential equations, including molecular dynamics simulation of many particle systems, to the finite element method. Attendant Mathematica programs or parts thereof are provided in conjunction with selected examples. Numerous links allow the reader to connect to related subjects and research topics. Among others this includes statistical mechanics (separate chapter), quantum mechanics, space flight, galactic dynamics, friction, and vibration spectroscopy. An introductory...

  6. Dynamical criteria for a unified gauge theory (including gravity)

    International Nuclear Information System (INIS)

    1979-01-01

    It is shown that local gauge invariance together with dynamical (and possibly Higgs) symmetry breaking can be taken as a basis for a unified gauge theory including gravity. The criterion for the breakdown of the linear gauge symmetry of the space-time sector turns out to be the absence of a prior geometry. The usual postulates of general relativity, such as general coordinate invariance, etc., follow from the above two criteria. Gravity actions that are natural from the point of view are discussed. The extension to superspace relevant to gauge supergroups is also given, including a large number of linear and quadratic superspace invariants

  7. Solar Energy Education. Renewable energy: a background text. [Includes glossary

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    Some of the most common forms of renewable energy are presented in this textbook for students. The topics include solar energy, wind power hydroelectric power, biomass ocean thermal energy, and tidal and geothermal energy. The main emphasis of the text is on the sun and the solar energy that it yields. Discussions on the sun's composition and the relationship between the earth, sun and atmosphere are provided. Insolation, active and passive solar systems, and solar collectors are the subtopics included under solar energy. (BCS)

  8. Meta-structure and tunable optical device including the same

    Energy Technology Data Exchange (ETDEWEB)

    Han, Seunghoon; Papadakis, Georgia Theano; Atwater, Harry

    2017-12-26

    A meta-structure and a tunable optical device including the same are provided. The meta-structure includes a plurality of metal layers spaced apart from one another, an active layer spaced apart from the plurality of metal layers and having a carrier concentration that is tuned according to an electric signal applied to the active layer and the plurality of metal layers, and a plurality of dielectric layers spaced apart from one another and each having one surface contacting a metal layer among the plurality of metal layers and another surface contacting the active layer.

  9. Methods of producing adsorption media including a metal oxide

    Science.gov (United States)

    Mann, Nicholas R; Tranter, Troy J

    2014-03-04

    Methods of producing a metal oxide are disclosed. The method comprises dissolving a metal salt in a reaction solvent to form a metal salt/reaction solvent solution. The metal salt is converted to a metal oxide and a caustic solution is added to the metal oxide/reaction solvent solution to adjust the pH of the metal oxide/reaction solvent solution to less than approximately 7.0. The metal oxide is precipitated and recovered. A method of producing adsorption media including the metal oxide is also disclosed, as is a precursor of an active component including particles of a metal oxide.

  10. Tunable cavity resonator including a plurality of MEMS beams

    Science.gov (United States)

    Peroulis, Dimitrios; Fruehling, Adam; Small, Joshua Azariah; Liu, Xiaoguang; Irshad, Wasim; Arif, Muhammad Shoaib

    2015-10-20

    A tunable cavity resonator includes a substrate, a cap structure, and a tuning assembly. The cap structure extends from the substrate, and at least one of the substrate and the cap structure defines a resonator cavity. The tuning assembly is positioned at least partially within the resonator cavity. The tuning assembly includes a plurality of fixed-fixed MEMS beams configured for controllable movement relative to the substrate between an activated position and a deactivated position in order to tune a resonant frequency of the tunable cavity resonator.

  11. Appraisal Of Quality Of Life Of Diabetic Patients, Including Life ...

    African Journals Online (AJOL)

    Appraisal Of Quality Of Life Of Diabetic Patients, Including Life Expectancy. ... of long-term complications, development of short-term complications, and physical symptoms and lifestyle changes resulting from the demands of the diabetic ... Key words: Type 2 Diabetes, quality of life, life expectancy, diabetic complications.

  12. Assessing the Doctoral Thesis When It Includes Published Work

    Science.gov (United States)

    Sharmini, Sharon; Spronken-Smith, Rachel; Golding, Clinton; Harland, Tony

    2015-01-01

    In this article we explore how examiners assess a thesis that includes published work. An online survey was used to gather data on approaches to assessing publication-based theses (PBTs). The respondents were 62 supervisors who had experience examining PBTs across a range of disciplines at a research-intensive university in New Zealand. Nearly…

  13. 25 CFR 20.308 - What does earned income include?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What does earned income include? 20.308 Section 20.308 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND..., the sale of farm crops, livestock, or professional artists producing art work); and (b) With regard to...

  14. 34 CFR 661.20 - What must an application include?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What must an application include? 661.20 Section 661.20 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION BUSINESS AND INTERNATIONAL EDUCATION PROGRAM How Does One Apply for a...

  15. Simple suggestions for including vertical physics in oil spill models

    International Nuclear Information System (INIS)

    D'Asaro, Eric; University of Washington, Seatle, WA

    2001-01-01

    Current models of oil spills include no vertical physics. They neglect the effect of vertical water motions on the transport and concentration of floating oil. Some simple ways to introduce vertical physics are suggested here. The major suggestion is to routinely measure the density stratification of the upper ocean during oil spills in order to develop a database on the effect of stratification. (Author)

  16. Truck Drivers And Risk Of STDs Including HIV

    Directory of Open Access Journals (Sweden)

    Bansal R.K

    1995-01-01

    Full Text Available Research Question: Whether long distance truck drivers are at a higher risk of contracting and transmitting STDs including HIV? Objectives: i To study the degree of knowledge of HIV and AIDS among long- distance truck drivers. ii Assess their sexual behaviour including condom use. iii Explore their prevailing social influences and substance abuse patterns. iv Explore their treatment seeking bahaviour as regards STDs. v Deduce their risk of contracting and transmitting STDs including HIV. Study Design: Cross- sectional interview. Setting: Transport Nagar, Indore (M.P Participants: 210 senior drivers (First drivers and 210 junior drivers (Second drivers. Study Variables: Extra-Marital sexual intercourse, condom usage, past and present history of STDs, treatment and counseling, substance abuse, social â€" cultural milieu. Outcome Variables: Risk of contraction of STDs. Statistical Analysis: Univariate analysis. Results: 94% of the drivers were totally ignorant about AIDS. 82.9% and 43.8 % of the senior and junior drivers had a history of extra- marital sex and of these only 2 regularly used condoms. 13.8% and 3.3 % of the senior and junior drivers had a past or present history suggestive of STD infection. Alcohol and Opium were regularly used by them. Conclusion: The studied drivers are at a high risk of contracting and transmitting STDs including HIV.

  17. Towards a general framework for including noise impacts in LCA

    NARCIS (Netherlands)

    Cucurachi, Stefano; Heijungs, Reinout; Ohlau, Katrin

    Purpose Several damages have been associated with the exposure of human beings to noise. These include auditory effects, i.e., hearing impairment, but also non-auditory physiological ones such as hypertension and ischemic heart disease, or psychological ones such as annoyance, depression, sleep

  18. 25 CFR 20.403 - What do protective services include?

    Science.gov (United States)

    2010-04-01

    ....403 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE... services, which may include, but are not limited to, the following: (i) Investigating and reporting on... for assistance in solving the social problems of individuals, families, and children. (5) Coordinating...

  19. Including Critical Thinking and Problem Solving in Physical Education

    Science.gov (United States)

    Pill, Shane; SueSee, Brendan

    2017-01-01

    Many physical education curriculum frameworks include statements about the inclusion of critical inquiry processes and the development of creativity and problem-solving skills. The learning environment created by physical education can encourage or limit the application and development of the learners' cognitive resources for critical and creative…

  20. Including Leap Year in the Canonical Birthday Problem

    Science.gov (United States)

    Nandor, M. J.

    2004-01-01

    The greatest benefit of including leap year in the calculation is not to increase precision, but to show students that a problem can be solved without such presumption. A birthday problem is analyzed showing that calculating a leap-year birthday probability is not a frivolous computation.

  1. Sexually transmitted infections, including HIV, in the Netherlands in 2006

    NARCIS (Netherlands)

    MG van Veen; FDH Koedijk; IVF van der Broek; ELM Op de Coul; IM de Boer; AI van Sighem; MAB van der Sande; soa-centra; Stichting HIV Monitoring; EPI/Cib

    2007-01-01

    The nationally covered low threshold STI centres offering STI care targeted at high risk groups, provide surveillance data to monitor national trends in STI, including HIV. In 2006, chlamydia remained the most commonly diagnosed bacterial STI in the Netherlands in the STI centres, in spite of

  2. Three-humped fission barrier transmission including vibrational damping

    International Nuclear Information System (INIS)

    Calabretta, L.; Del Zoppo, A.; Ingrao, G.

    1978-01-01

    The total penetrability through a three-humped fission barrier including vibrational damping is calculated by using an optical model for fission. The Bondorf's stationary probability current theory is used for transitions among class-1, class-2 and class-3 phases. A method to calculate the partial-transmission coefficients is developed

  3. Information for Teachers (Including Classroom Activities), Skylab Student Project.

    Science.gov (United States)

    National Aeronautics and Space Administration, Washington, DC.

    This program is intended to directly involve the educational community in space experiments, many of which can be related to existing curricula. Included in this first packet are: 1) a brief description of the Skylab Program and the National Science Teachers Association-National Aeronautics and Space Administration (NSTA-NASA) Skylab Student…

  4. Smart Antenna Skins, including Conformal Array, MMICs and Applications

    NARCIS (Netherlands)

    Bogaart, F.L.M. van den

    2000-01-01

    Low-cost technologies are presented for future space-borne and airborne SAR systems. These technologies include state-of-the art highly integrated circuits to miniaturise front-end, solutions to lower-cost interconnection technologies, new beamforming aspects and new architectures. The MMICs address

  5. Including Students with Severe Disabilities in General Education Settings.

    Science.gov (United States)

    Wisniewski, Lech; Alper, Sandra

    1994-01-01

    This paper presents five systematic phases for bringing about successful regular education inclusion of students with severe disabilities. Phases include develop networks within the community, assess school and community resources, review strategies for integration, install strategies that lead to integration, and develop a system of feedback and…

  6. Including patients’ perspectives in patient information leaflets: A polyocular approach

    DEFF Research Database (Denmark)

    Fage-Butler, Antoinette Mary

    2013-01-01

    Existing research reveals that patients’ perspectives are missing from mandatory patient information leaflets (PILs). At the same time, there is overwhelming consensus that they should be included in this genre, and a corresponding need for potential approaches to tackle this problem. This paper ...

  7. Everglades National Park Including Biscayne National Park. Activity Book.

    Science.gov (United States)

    Ruehrwein, Dick

    Intended to help elementary school children learn about the resources of the Everglades and Biscayne National Parks, this activity book includes information, puzzles, games, and quizzes. The booklet deals with concepts related to: (1) the seasons; (2) fire ecology; (3) water; (4) fish; (5) mammals; (6) mosquitos; (7) birds; (8) venomous snakes;…

  8. 10 CFR 905.11 - What must an IRP include?

    Science.gov (United States)

    2010-01-01

    ... DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Integrated Resource Planning § 905.11 What must an IRP include? (a) General. Integrated resource planning is a planning process for new energy... projected durability of such savings measured over time; and must treat demand and supply resources on a...

  9. LTRACK: Beam-transport calculation including wakefield effects

    International Nuclear Information System (INIS)

    Chan, K.C.D.; Cooper, R.K.

    1988-01-01

    LTRACK is a first-order beam-transport code that includes wakefield effects up to quadrupole modes. This paper will introduce the readers to this computer code by describing the history, the method of calculations, and a brief summary of the input/output information. Future plans for the code will also be described

  10. Visual Impairments, "Including Blindness." NICHCY Disability Fact Sheet #13

    Science.gov (United States)

    National Dissemination Center for Children with Disabilities, 2012

    2012-01-01

    Vision is one of the five senses. Being able to see gives tremendous access to learning about the world around--people's faces and the subtleties of expression, what different things look like and how big they are, and the physical environments, including approaching hazards. When a child has a visual impairment, it is cause for immediate…

  11. 34 CFR 429.20 - What must an application include?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What must an application include? 429.20 Section 429.20 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION BILINGUAL VOCATIONAL MATERIALS, METHODS, AND TECHNIQUES PROGRAM...

  12. Interviewing Objects: Including Educational Technologies as Qualitative Research Participants

    Science.gov (United States)

    Adams, Catherine A.; Thompson, Terrie Lynn

    2011-01-01

    This article argues the importance of including significant technologies-in-use as key qualitative research participants when studying today's digitally enhanced learning environments. We gather a set of eight heuristics to assist qualitative researchers in "interviewing" technologies-in-use (or other relevant objects), drawing on concrete…

  13. Oat have multifunctional uses including animal feed, human food ...

    African Journals Online (AJOL)

    Akademia Rolnicza

    2014-07-11

    Jul 11, 2014 ... Abstract. The objective of the work was to evaluate the influence of genetic and mechanical removal of hulls from oat grains on their nutrient content. The studies included three cultivars and six lines of oat grains. In grain samples of hulled (5 samples), dehulled (5 samples) and naked (4 samples) oats, the ...

  14. Modeling Electric Double-Layers Including Chemical Reaction Effects

    DEFF Research Database (Denmark)

    Paz-Garcia, Juan Manuel; Johannesson, Björn; Ottosen, Lisbeth M.

    2014-01-01

    A physicochemical and numerical model for the transient formation of an electric double-layer between an electrolyte and a chemically-active flat surface is presented, based on a finite elements integration of the nonlinear Nernst-Planck-Poisson model including chemical reactions. The model works...

  15. Including the gifted learner: perceptions of South African teachers ...

    African Journals Online (AJOL)

    Qualitative content analysis revealed the following themes: inclusive education and the learner who is gifted; curriculum differentiation; obstacles to curriculum differentiation; and possible solutions for more effectively including the gifted learner. Despite their diversity in terms of culture, language and positioning by the ...

  16. Payment Services for Global Online Systems Including Internet.

    Science.gov (United States)

    Seebeck, Bill; And Others

    1995-01-01

    A panel of four conference presenters address issues related to paying for services provided through online systems. Discussion includes the following topics: metering devices; electronic/digital cash; working within existing banking/credit card structures; provision of payment mechanisms in countries without extensive credit card usage; and…

  17. Restructuring the Public School Curriculum To Include Parenting Education Classes.

    Science.gov (United States)

    Tyree, Carolyn L.; And Others

    Although the current educational climate stresses a back-to-basics approach, there is nonetheless overwhelming evidence of a need for an appropriately structured parenting education program in the public school curriculum. Reasons for this need include the large number of teenage pregnancies and abortions. These lead teens to miss high school…

  18. Can We Include The Third Dimension During Image Mining?

    Indian Academy of Sciences (India)

    Table of contents. Can We Include The Third Dimension During Image Mining? Retrieve An Image · Content-Based Retrieval · Problem Statement · Slide 5 · CBIR Methodology · Slide 7 · Illustration : Logo Search · Illustration: Arbitrary Query · Limitations · Illustration: Change in View · Slide 12 · Illustration: Depth Variation.

  19. Microfluidic System Simulation Including the Electro-Viscous Effect

    Science.gov (United States)

    Rojas, Eileen; Chen, C. P.; Majumdar, Alok

    2007-01-01

    This paper describes a practical approach using a general purpose lumped-parameter computer program, GFSSP (Generalized Fluid System Simulation Program) for calculating flow distribution in a network of micro-channels including electro-viscous effects due to the existence of electrical double layer (EDL). In this study, an empirical formulation for calculating an effective viscosity of ionic solutions based on dimensional analysis is described to account for surface charge and bulk fluid conductivity, which give rise to electro-viscous effect in microfluidics network. Two dimensional slit micro flow data was used to determine the model coefficients. Geometry effect is then included through a Poiseuille number correlation in GFSSP. The bi-power model was used to calculate flow distribution of isotropically etched straight channel and T-junction microflows involving ionic solutions. Performance of the proposed model is assessed against experimental test data.

  20. Suddenly included: cultural differences in experiencing re-inclusion.

    Science.gov (United States)

    Pfundmair, Michaela; Graupmann, Verena; Du, Hongfei; Frey, Dieter; Aydin, Nilüfer

    2015-03-01

    In the current research, we examined whether re-inclusion (i.e. the change from a previous state of exclusion to a new state of inclusion) was perceived differently by people with individualistic and collectivistic cultural backgrounds. Individualists (German and Austrian participants) but not collectivists (Chinese participants) experienced re-inclusion differently than continued inclusion: While collectivistic participants did not differentiate between both kinds of inclusion, individualistic participants showed reduced fulfilment of their psychological needs under re-inclusion compared to continued inclusion. The results moreover revealed that only participants from individualistic cultures expressed more feelings of exclusion when re-included than when continually included. These exclusionary feelings partially mediated the relationship between the different states of inclusion and basic need fulfilment. © 2014 International Union of Psychological Science.

  1. Progressive IRP Models for Power Resources Including EPP

    Directory of Open Access Journals (Sweden)

    Yiping Zhu

    2017-01-01

    Full Text Available In the view of optimizing regional power supply and demand, the paper makes effective planning scheduling of supply and demand side resources including energy efficiency power plant (EPP, to achieve the target of benefit, cost, and environmental constraints. In order to highlight the characteristics of different supply and demand resources in economic, environmental, and carbon constraints, three planning models with progressive constraints are constructed. Results of three models by the same example show that the best solutions to different models are different. The planning model including EPP has obvious advantages considering pollutant and carbon emission constraints, which confirms the advantages of low cost and emissions of EPP. The construction of progressive IRP models for power resources considering EPP has a certain reference value for guiding the planning and layout of EPP within other power resources and achieving cost and environmental objectives.

  2. How Do We Include Underrepresented Voices in the Sustainability Conversation?

    Directory of Open Access Journals (Sweden)

    Virajita Singh

    2018-02-01

    Full Text Available In a speech given at the Regional Sustainable Development Partnerships 20th Anniversary Statewide Event in the Cargill Building on the St. Paul Campus of the University of Minnesota on November 21, 2017, Virajita Singh, Assistant Vice Provost in the Office for Equity and Diversity, addressed the question, “How do we include underrepresented voices in the sustainability conversation?” The speech describes the work of The Partnerships as observed by the speaker, and its connection to the Design for Community Resilience program. It also introduces the concepts of Partnership and Design Thinking, and suggests a process for including underrepresented voices in the work informed by Design Thinking.  

  3. 3D integrated HYDRA simulations of hohlraums including fill tubes

    Science.gov (United States)

    Marinak, M. M.; Milovich, J.; Hammel, B. A.; Macphee, A. G.; Smalyuk, V. A.; Kerbel, G. D.; Sepke, S.; Patel, M. V.

    2017-10-01

    Measurements of fill tube perturbations from hydro growth radiography (HGR) experiments on the National Ignition Facility show spoke perturbations in the ablator radiating from the base of the tube. These correspond to the shadow of the 10 μm diameter glass fill tube cast by hot spots at early time. We present 3D integrated HYDRA simulations of these experiments which include the fill tube. Meshing techniques are described which were employed to resolve the fill tube structure and associated perturbations in the simulations. We examine the extent to which the specific illumination geometry necessary to accommodate a backlighter in the HGR experiment contributes to the spoke pattern. Simulations presented include high resolution calculations run on the Trinity machine operated by the Alliance for Computing at Extreme Scale (ACES) partnership. This work was performed under the auspices of the Lawrence Livermore National Security, LLC, (LLNS) under Contract No. DE-AC52-07NA27344.

  4. Survey of state legislative programs that include passive solar energy

    Energy Technology Data Exchange (ETDEWEB)

    Weiss, S

    1979-06-01

    This report surveys and evaluates state-level solar-incentive programs, including passive solar energy. The range of programs examined focuses on financial and legal incentives designed to speed the implementation of solar heating, cooling, and hot water systems. They have been evaluated by probing the wording of the incentive legislation and by interviewing state program administrators in each state to determine: (1) the extent, if any, of passive inclusion in solar-incentive programs, and (2) the level of success that various implementation techniques have achieved for encouraging passive solar designs as opposed to the more-commonly-understood active systems. Because no states have initiated incentive legislation designed exclusively to encourage passive solar techniques, it has been essential to determine whether legislative programs explicitly or implicitly include passive solar or if they explicitly exclude it.

  5. Energy storage device including a redox-enhanced electrolyte

    Science.gov (United States)

    Stucky, Galen; Evanko, Brian; Parker, Nicholas; Vonlanthen, David; Auston, David; Boettcher, Shannon; Chun, Sang-Eun; Ji, Xiulei; Wang, Bao; Wang, Xingfeng; Chandrabose, Raghu Subash

    2017-08-08

    An electrical double layer capacitor (EDLC) energy storage device is provided that includes at least two electrodes and a redox-enhanced electrolyte including two redox couples such that there is a different one of the redox couples for each of the electrodes. When charged, the charge is stored in Faradaic reactions with the at least two redox couples in the electrolyte and in a double-layer capacitance of a porous carbon material that comprises at least one of the electrodes, and a self-discharge of the energy storage device is mitigated by at least one of electrostatic attraction, adsorption, physisorption, and chemisorption of a redox couple onto the porous carbon material.

  6. Improving the strength of amalgams by including steel fibers

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, Calvin T. [Hendrix College, Conway, AR 72032 (United States); Van Hoose, James R. [Siemens, Orlando, FL 32826 (United States); McGill, Preston B. [Marshall Space Flight Center, EM20, Huntsville, AL 35812 (United States); Grugel, Richard N., E-mail: richard.n.grugel@nasa.gov [Marshall Space Flight Center, EM30, Huntsville, AL 35812 (United States)

    2012-05-30

    Highlights: Black-Right-Pointing-Pointer A room temperature liquid Ga-In alloy was successfully substituted for mercury. Black-Right-Pointing-Pointer Physically sound amalgams with included steel fibers can be made. Black-Right-Pointing-Pointer A small volume fraction inclusion of fibers increased strength by {approx}20%. - Abstract: Mercury amalgams, due to their material properties, are widely and successfully used in dental practice. They are, however, also well recognized as having poor tensile strength. With the possibility of expanding amalgam applications it is demonstrated that tensile strength can be increased some 20% by including a small amount of steel fibers. Furthermore, it is shown that mercury can be replaced with a room temperature liquid gallium-indium alloy. Processing, microstructures, and mechanical test results of these novel amalgams are presented and discussed in view of means to further improve their properties.

  7. QCD Reggeon field theory for every day: Pomeron loops included

    International Nuclear Information System (INIS)

    Altinoluk, Tolga; Kovner, Alex; Peressutti, Javier; Lublinsky, Michael

    2009-01-01

    We derive the evolution equation for hadronic scattering amplitude at high energy. Our derivation includes the nonlinear effects of finite partonic density in the hadronic wave function as well as the effect of multiple scatterings for scattering on dense hadronic target. It thus includes Pomeron loops. It is based on the evolution of the hadronic wave function derived in /cite{foam}. The kernel of the evolution equation defines the second quantized Hamiltonian of the QCD Reggeon Field Theory, H RFT beyond the limits considered so far. The two previously known limits of the evolution: dilute target (JIMWLK limit) and dilute projectile (KLWMIJ limit) are recovered directly from our final result. The Hamiltonian H RFT is applicable for the evolution of scattering amplitude for arbitrarily dense hadronic projectiles/targets - from 'dipole-dipole' to 'nucleus-nucleus' scattering processes.

  8. Smart Farming: Including Rights Holders for Responsible Agricultural Innovation

    OpenAIRE

    Kelly Bronson

    2018-01-01

    This article draws on the literature of responsible innovation to suggest concrete processes for including rights holders in the “smart” agricultural revolution. It first draws upon historical agricultural research in Canada to highlight how productivist values drove seed innovations with particular consequences for the distribution of power in the food system. Next, the article uses document analysis to suggest that a similar value framework is motivating public investment in smart farming i...

  9. Production, control and utilization of radioisotopes including radiopharmaceuticals

    International Nuclear Information System (INIS)

    Muenze, R.

    1985-05-01

    From April 29th to May 5th, 1984 27 participants from 21 developing countries stayed within an IAEA Study Tour ('Production, Control and Utilization of Radioisotopes including Radiopharmaceuticals') in the GDR. In the CINR, Rossendorf the reactor, the cyclotron, the technological centre as well as the animal test laboratory were visited. The participants were made familiar by 10 papers with the development, production and control of radiopharmaceuticals in the CINR, Rossendorf. (author)

  10. Information to Include in Curriculum Vitae | Cancer Prevention Fellowship Program

    Science.gov (United States)

    Applicants are encouraged to use their current curriculum vitae and to add any necessary information. Please include your name and a page number on each page of the curriculum vitae. Some of the information requested below will not be applicable to all individuals. Please do not print or type your information on this page. Personal Information Name (First middle last) Gender (optional) Race (optional) Date of birth Place of birth (city,

  11. 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)

  12. How to include farmers in the emission trading system?

    OpenAIRE

    Svendsen, Gert Tinggaard

    2011-01-01

    The EU has committed itself to an ambitious 20% reduction of greenhouse gases (GHG) by 2020 compared to the 1990 emissions level. Moreover, the EU goal beyond 2012 is to strengthen, expand and improve climate change initiatives. Therefore, there is a strong need to consider more carefully how to integrate as many sectors as possible in these efforts. Farmers, however, do not trade GHG under the Kyoto agreement. The idea of including farmers in a national emission trading system has been launc...

  13. GNSS-Based Space Weather Systems Including COSMIC Ionospheric Measurements

    Science.gov (United States)

    Komjathy, Attila; Mandrake, Lukas; Wilson, Brian; Iijima, Byron; Pi, Xiaoqing; Hajj, George; Mannucci, Anthony J.

    2006-01-01

    The presentation outline includes University Corporation for Atmospheric Research (UCAR) and Jet Propulsion Laboratory (JPL) product comparisons, assimilating ground-based global positioning satellites (GPS) and COSMIC into JPL/University of Southern California (USC) Global Assimilative Ionospheric Model (GAIM), and JPL/USC GAIM validation. The discussion of comparisons examines Abel profiles and calibrated TEC. The JPL/USC GAIM validation uses Arecibo ISR, Jason-2 VTEC, and Abel profiles.

  14. A Framework for Including Family Health Spillovers in Economic Evaluation

    Science.gov (United States)

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-01-01

    Health care interventions may affect the health of patients’ family networks. It has been suggested that these “health spillovers” should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the “health care perspective”). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society. PMID:26377370

  15. A Framework for Including Family Health Spillovers in Economic Evaluation.

    Science.gov (United States)

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-02-01

    Health care interventions may affect the health of patients' family networks. It has been suggested that these "health spillovers" should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the "health care perspective"). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society. © The Author(s) 2015.

  16. Modeling heart rate variability including the effect of sleep stages

    Science.gov (United States)

    Soliński, Mateusz; Gierałtowski, Jan; Żebrowski, Jan

    2016-02-01

    We propose a model for heart rate variability (HRV) of a healthy individual during sleep with the assumption that the heart rate variability is predominantly a random process. Autonomic nervous system activity has different properties during different sleep stages, and this affects many physiological systems including the cardiovascular system. Different properties of HRV can be observed during each particular sleep stage. We believe that taking into account the sleep architecture is crucial for modeling the human nighttime HRV. The stochastic model of HRV introduced by Kantelhardt et al. was used as the initial starting point. We studied the statistical properties of sleep in healthy adults, analyzing 30 polysomnographic recordings, which provided realistic information about sleep architecture. Next, we generated synthetic hypnograms and included them in the modeling of nighttime RR interval series. The results of standard HRV linear analysis and of nonlinear analysis (Shannon entropy, Poincaré plots, and multiscale multifractal analysis) show that—in comparison with real data—the HRV signals obtained from our model have very similar properties, in particular including the multifractal characteristics at different time scales. The model described in this paper is discussed in the context of normal sleep. However, its construction is such that it should allow to model heart rate variability in sleep disorders. This possibility is briefly discussed.

  17. Electrolytes including fluorinated solvents for use in electrochemical cells

    Science.gov (United States)

    Tikhonov, Konstantin; Yip, Ka Ki; Lin, Tzu-Yuan

    2015-07-07

    Provided are electrochemical cells and electrolytes used to build such cells. The electrolytes include ion-supplying salts and fluorinated solvents capable of maintaining single phase solutions with the salts at between about -30.degree. C. to about 80.degree. C. The fluorinated solvents, such as fluorinated carbonates, fluorinated esters, and fluorinated esters, are less flammable than their non-fluorinated counterparts and increase safety characteristics of cells containing these solvents. The amount of fluorinated solvents in electrolytes may be between about 30% and 80% by weight not accounting weight of the salts. Fluorinated salts, such as fluoroalkyl-substituted LiPF.sub.6, fluoroalkyl-substituted LiBF.sub.4 salts, linear and cyclic imide salts as well as methide salts including fluorinated alkyl groups, may be used due to their solubility in the fluorinated solvents. In some embodiments, the electrolyte may also include a flame retardant, such as a phosphazene or, more specifically, a cyclic phosphazene and/or one or more ionic liquids.

  18. The COG database: an updated version includes eukaryotes

    Directory of Open Access Journals (Sweden)

    Sverdlov Alexander V

    2003-09-01

    Full Text Available Abstract Background The availability of multiple, essentially complete genome sequences of prokaryotes and eukaryotes spurred both the demand and the opportunity for the construction of an evolutionary classification of genes from these genomes. Such a classification system based on orthologous relationships between genes appears to be a natural framework for comparative genomics and should facilitate both functional annotation of genomes and large-scale evolutionary studies. Results We describe here a major update of the previously developed system for delineation of Clusters of Orthologous Groups of proteins (COGs from the sequenced genomes of prokaryotes and unicellular eukaryotes and the construction of clusters of predicted orthologs for 7 eukaryotic genomes, which we named KOGs after eukaryotic orthologous groups. The COG collection currently consists of 138,458 proteins, which form 4873 COGs and comprise 75% of the 185,505 (predicted proteins encoded in 66 genomes of unicellular organisms. The eukaryotic orthologous groups (KOGs include proteins from 7 eukaryotic genomes: three animals (the nematode Caenorhabditis elegans, the fruit fly Drosophila melanogaster and Homo sapiens, one plant, Arabidopsis thaliana, two fungi (Saccharomyces cerevisiae and Schizosaccharomyces pombe, and the intracellular microsporidian parasite Encephalitozoon cuniculi. The current KOG set consists of 4852 clusters of orthologs, which include 59,838 proteins, or ~54% of the analyzed eukaryotic 110,655 gene products. Compared to the coverage of the prokaryotic genomes with COGs, a considerably smaller fraction of eukaryotic genes could be included into the KOGs; addition of new eukaryotic genomes is expected to result in substantial increase in the coverage of eukaryotic genomes with KOGs. Examination of the phyletic patterns of KOGs reveals a conserved core represented in all analyzed species and consisting of ~20% of the KOG set. This conserved portion of the

  19. Global anthropogenic emissions of particulate matter including black carbon

    Science.gov (United States)

    Klimont, Zbigniew; Kupiainen, Kaarle; Heyes, Chris; Purohit, Pallav; Cofala, Janusz; Rafaj, Peter; Borken-Kleefeld, Jens; Schöpp, Wolfgang

    2017-07-01

    This paper presents a comprehensive assessment of historical (1990-2010) global anthropogenic particulate matter (PM) emissions including the consistent and harmonized calculation of mass-based size distribution (PM1, PM2. 5, PM10), as well as primary carbonaceous aerosols including black carbon (BC) and organic carbon (OC). The estimates were developed with the integrated assessment model GAINS, where source- and region-specific technology characteristics are explicitly included. This assessment includes a number of previously unaccounted or often misallocated emission sources, i.e. kerosene lamps, gas flaring, diesel generators, refuse burning; some of them were reported in the past for selected regions or in the context of a particular pollutant or sector but not included as part of a total estimate. Spatially, emissions were calculated for 172 source regions (as well as international shipping), presented for 25 global regions, and allocated to 0.5° × 0.5° longitude-latitude grids. No independent estimates of emissions from forest fires and savannah burning are provided and neither windblown dust nor unpaved roads emissions are included. We estimate that global emissions of PM have not changed significantly between 1990 and 2010, showing a strong decoupling from the global increase in energy consumption and, consequently, CO2 emissions, but there are significantly different regional trends, with a particularly strong increase in East Asia and Africa and a strong decline in Europe, North America, and the Pacific region. This in turn resulted in important changes in the spatial pattern of PM burden, e.g. European, North American, and Pacific contributions to global emissions dropped from nearly 30 % in 1990 to well below 15 % in 2010, while Asia's contribution grew from just over 50 % to nearly two-thirds of the global total in 2010. For all PM species considered, Asian sources represented over 60 % of the global anthropogenic total, and residential combustion

  20. Global anthropogenic emissions of particulate matter including black carbon

    Directory of Open Access Journals (Sweden)

    Z. Klimont

    2017-07-01

    Full Text Available This paper presents a comprehensive assessment of historical (1990–2010 global anthropogenic particulate matter (PM emissions including the consistent and harmonized calculation of mass-based size distribution (PM1, PM2. 5, PM10, as well as primary carbonaceous aerosols including black carbon (BC and organic carbon (OC. The estimates were developed with the integrated assessment model GAINS, where source- and region-specific technology characteristics are explicitly included. This assessment includes a number of previously unaccounted or often misallocated emission sources, i.e. kerosene lamps, gas flaring, diesel generators, refuse burning; some of them were reported in the past for selected regions or in the context of a particular pollutant or sector but not included as part of a total estimate. Spatially, emissions were calculated for 172 source regions (as well as international shipping, presented for 25 global regions, and allocated to 0.5°  ×  0.5° longitude–latitude grids. No independent estimates of emissions from forest fires and savannah burning are provided and neither windblown dust nor unpaved roads emissions are included. We estimate that global emissions of PM have not changed significantly between 1990 and 2010, showing a strong decoupling from the global increase in energy consumption and, consequently, CO2 emissions, but there are significantly different regional trends, with a particularly strong increase in East Asia and Africa and a strong decline in Europe, North America, and the Pacific region. This in turn resulted in important changes in the spatial pattern of PM burden, e.g. European, North American, and Pacific contributions to global emissions dropped from nearly 30 % in 1990 to well below 15 % in 2010, while Asia's contribution grew from just over 50 % to nearly two-thirds of the global total in 2010. For all PM species considered, Asian sources represented over 60 % of the global

  1. Generalized fluid theory including non-Maxwellian kinetic effects

    Science.gov (United States)

    Izacard, Olivier

    2017-04-01

    The results obtained by the plasma physics community for the validation and the prediction of turbulence and transport in magnetized plasmas come mainly from the use of very central processing unit (CPU)-consuming particle-in-cell or (gyro)kinetic codes which naturally include non-Maxwellian kinetic effects. To date, fluid codes are not considered to be relevant for the description of these kinetic effects. Here, after revisiting the limitations of the current fluid theory developed in the 19th century, we generalize the fluid theory including kinetic effects such as non-Maxwellian super-thermal tails with as few fluid equations as possible. The collisionless and collisional fluid closures from the nonlinear Landau Fokker-Planck collision operator are shown for an arbitrary collisionality. Indeed, the first fluid models associated with two examples of collisionless fluid closures are obtained by assuming an analytic non-Maxwellian distribution function (e.g. the INMDF (Izacard, O. 2016b Kinetic corrections from analytic non-Maxwellian distribution functions in magnetized plasmas. Phys. Plasmas 23, 082504) that stands for interpreted non-Maxwellian distribution function). One of the main differences with the literature is our analytic representation of the distribution function in the velocity phase space with as few hidden variables as possible thanks to the use of non-orthogonal basis sets. These new non-Maxwellian fluid equations could initiate the next generation of fluid codes including kinetic effects and can be expanded to other scientific disciplines such as astrophysics, condensed matter or hydrodynamics. As a validation test, we perform a numerical simulation based on a minimal reduced INMDF fluid model. The result of this test is the discovery of the origin of particle and heat diffusion. The diffusion is due to the competition between a growing INMDF on short time scales due to spatial gradients and the thermalization on longer time scales. The results

  2. Early Course in Obstetrics Increases Likelihood of Practice Including Obstetrics.

    Science.gov (United States)

    Pearson, Jennifer; Westra, Ruth

    2016-10-01

    The Department of Family Medicine and Community Health Duluth has offered the Obstetrical Longitudinal Course (OBLC) as an elective for first-year medical students since 1999. The objective of the OBLC Impact Survey was to assess the effectiveness of the course over the past 15 years. A Qualtrics survey was emailed to participants enrolled in the course from 1999-2014. Data was compiled for the respondent group as a whole as well as four cohorts based on current level of training/practice. Cross-tabulations with Fisher's exact test were applied and odds ratios calculated for factors affecting likelihood of eventual practice including obstetrics. Participation in the OBLC was successful in increasing exposure, awareness, and comfort in caring for obstetrical patients and feeling more prepared for the OB-GYN Clerkship. A total of 50.5% of course participants felt the OBLC influenced their choice of specialty. For participants who are currently physicians, 51% are practicing family medicine with obstetrics or OB-GYN. Of the cohort of family physicians, 65.2% made the decision whether to include obstetrics in practice during medical school. Odds ratios show the likelihood of practicing obstetrics is higher when participants have completed the OBLC and also are practicing in a rural community. Early exposure to obstetrics, as provided by the OBLC, appears to increase the likelihood of including obstetrics in practice, especially if eventual practice is in a rural community. This course may be a tool to help create a pipeline for future rural family physicians providing obstetrical care.

  3. How to include farmers in the emission trading system?

    DEFF Research Database (Denmark)

    Svendsen, Gert Tinggaard

    2011-01-01

    The EU has committed itself to an ambitious 20 % reduction of greenhouse gases (GHG) by 2020 compared to the 1990 emissions level. Moreover, the EU goal beyond 2012 is to strengthen, expand and improve climate change initiatives. Therefore, there is a strong need to consider more carefully how...... to integrate as many sectors as possible in these efforts. Farmers, however, do not trade GHG under the Kyoto agreement. The idea of including farmers in a national emission trading system has been launched in Australia but it has not yet been applied to the EU....

  4. Smart Farming: Including Rights Holders for Responsible Agricultural Innovation

    Directory of Open Access Journals (Sweden)

    Kelly Bronson

    2018-02-01

    Full Text Available This article draws on the literature of responsible innovation to suggest concrete processes for including rights holders in the “smart” agricultural revolution. It first draws upon historical agricultural research in Canada to highlight how productivist values drove seed innovations with particular consequences for the distribution of power in the food system. Next, the article uses document analysis to suggest that a similar value framework is motivating public investment in smart farming innovations. The article is of interest to smart farming’s decision makers (from farmers to governance actors and a broader audience – anyone interested in engendering equity through innovation-led societal transitions.

  5. Luminous variable stars with naked eye: data reduction including extinction

    Science.gov (United States)

    Sigismondi, Costantino

    2014-05-01

    The observation of variable stars from urban contexts is hampered by city lights and field of view. Some bright stars like Betelgeuse and Antares are visible from the majority of cities, and during clear nights can be accurately estimated with the naked eye. The reference stars should be bright stars, not necessarily at the same altitude, including the atmospheric extinction in the data reduction. The software Stellarium 0.12.4 calculates well the standard atmospheric extinction with stars at least 10 degrees above the horizon. The accuracy of visual estimations is better than 0.1 magnitudes.

  6. Composite armor, armor system and vehicle including armor system

    Science.gov (United States)

    Chu, Henry S.; Jones, Warren F.; Lacy, Jeffrey M.; Thinnes, Gary L.

    2013-01-01

    Composite armor panels are disclosed. Each panel comprises a plurality of functional layers comprising at least an outermost layer, an intermediate layer and a base layer. An armor system incorporating armor panels is also disclosed. Armor panels are mounted on carriages movably secured to adjacent rails of a rail system. Each panel may be moved on its associated rail and into partially overlapping relationship with another panel on an adjacent rail for protection against incoming ordnance from various directions. The rail system may be configured as at least a part of a ring, and be disposed about a hatch on a vehicle. Vehicles including an armor system are also disclosed.

  7. Including investment risk in large-scale power market models

    DEFF Research Database (Denmark)

    Lemming, Jørgen Kjærgaard; Meibom, P.

    2003-01-01

    can be included in large-scale partial equilibrium models of the power market. The analyses are divided into a part about risk measures appropriate for power market investors and a more technical part about the combination of a risk-adjustment model and a partial-equilibrium model. To illustrate...... the analyses quantitatively, a framework based on an iterative interaction between the equilibrium model and a separate risk-adjustment module was constructed. To illustrate the features of the proposed modelling approach we examined how uncertainty in demand and variable costs affects the optimal choice...

  8. Composite material including nanocrystals and methods of making

    Science.gov (United States)

    Bawendi, Moungi G.; Sundar, Vikram C.

    2010-04-06

    Temperature-sensing compositions can include an inorganic material, such as a semiconductor nanocrystal. The nanocrystal can be a dependable and accurate indicator of temperature. The intensity of emission of the nanocrystal varies with temperature and can be highly sensitive to surface temperature. The nanocrystals can be processed with a binder to form a matrix, which can be varied by altering the chemical nature of the surface of the nanocrystal. A nanocrystal with a compatibilizing outer layer can be incorporated into a coating formulation and retain its temperature sensitive emissive properties.

  9. Including Torsional Anharmonicity in Canonical and Microcanonical Reaction Path Calculations.

    Science.gov (United States)

    Zheng, Jingjing; Truhlar, Donald G

    2013-07-09

    We reformulate multistructural variational transition state theory by removing the approximation of calculating torsional anharmonicity only at stationary points. The multistructural method with torsional anharmonicity is applied to calculate the reaction-path free energy of the hydrogen abstraction from the carbon-1 position in isobutanol by OH radical. The torsional potential anharmonicity along the reaction path is taken into account by a coupled torsional potential. The calculations show that it can be critical to include torsional anharmonicity in searching for canonical and microcanonical variational transition states. The harmonic-oscillator approximation fails to yield reasonable free energy curves along the reaction path.

  10. Solution of neutron slowing down equation including multiple inelastic scattering

    International Nuclear Information System (INIS)

    El-Wakil, S.A.; Saad, A.E.

    1977-01-01

    The present work is devoted the presentation of an analytical method for the calculation of elastically and inelastically slowed down neutrons in an infinite non absorbing homogeneous medium. On the basis of the Central limit theory (CLT) and the integral transform technique the slowing down equation including inelastic scattering in terms of the Green function of elastic scattering is solved. The Green function is decomposed according to the number of collisions. A formula for the flux at any lethargy O (u) after any number of collisions is derived. An equation for the asymptotic flux is also obtained

  11. Computer Simulation of the Solidification Process Including Air Gap Formation

    Directory of Open Access Journals (Sweden)

    Skrzypczak T.

    2017-12-01

    Full Text Available The paper presents an approach of numerical modelling of alloy solidification in permanent mold and transient heat transport between the casting and the mold in two-dimensional space. The gap of time-dependent width called "air gap", filled with heat conducting gaseous medium is included in the model. The coefficient of thermal conductivity of the gas filling the space between the casting and the mold is small enough to introduce significant thermal resistance into the heat transport process. The mathematical model of heat transport is based on the partial differential equation of heat conduction written independently for the solidifying region and the mold. Appropriate solidification model based on the latent heat of solidification is also included in the mathematical description. These equations are supplemented by appropriate initial and boundary conditions. The formation process of air gap depends on the thermal deformations of the mold and the casting. The numerical model is based on the finite element method (FEM with independent spatial discretization of interacting regions. It results in multi-mesh problem because the considered regions are disconnected.

  12. Exclusive queueing model including the choice of service windows

    Science.gov (United States)

    Tanaka, Masahiro; Yanagisawa, Daichi; Nishinari, Katsuhiro

    2018-01-01

    In a queueing system involving multiple service windows, choice behavior is a significant concern. This paper incorporates the choice of service windows into a queueing model with a floor represented by discrete cells. We contrived a logit-based choice algorithm for agents considering the numbers of agents and the distances to all service windows. Simulations were conducted with various parameters of agent choice preference for these two elements and for different floor configurations, including the floor length and the number of service windows. We investigated the model from the viewpoint of transit times and entrance block rates. The influences of the parameters on these factors were surveyed in detail and we determined that there are optimum floor lengths that minimize the transit times. In addition, we observed that the transit times were determined almost entirely by the entrance block rates. The results of the presented model are relevant to understanding queueing systems including the choice of service windows and can be employed to optimize facility design and floor management.

  13. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  14. Proposal to Include Electrical Energy in the Industrial Return Statistics

    CERN Document Server

    2003-01-01

    At its 108th session on the 20 June 1997, the Council approved the Report of the Finance Committee Working Group on the Review of CERN Purchasing Policy and Procedures. Among other topics, the report recommended the inclusion of utility supplies in the calculation of the return statistics as soon as the relevant markets were deregulated, without reaching a consensus on the exact method of calculation. At its 296th meeting on the 18 June 2003, the Finance Committee approved a proposal to award a contract for the supply of electrical energy (CERN/FC/4693). The purpose of the proposal in this document is to clarify the way electrical energy will be included in future calculations of the return statistics. The Finance Committee is invited: 1. to agree that the full cost to CERN of electrical energy (excluding the cost of transport) be included in the Industrial Service return statistics; 2. to recommend that the Council approves the corresponding amendment to the Financial Rules set out in section 2 of this docum...

  15. TOOLS TO INCLUDE BLIND STUDENTS IN SCHOOL BUILDING PERFORMANCE ASSESSMENTS

    Directory of Open Access Journals (Sweden)

    Tania Pietzschke Abate

    2016-05-01

    Full Text Available This article discusses the design of data collection instruments that include the opinions of blind students, in accordance with the principles of Universal Design (UD. The aim of this study is to understand the importance of adapting data collection instruments for the inclusion of disabled persons in field research in Architecture and Design, among other fields. The data collection instruments developed were a play interview with a tactile map and a 3D survey with the use of tactile models. These instruments sought to assess the school environment experienced by blind students. The study involved students from the early years of a school for the blind who had not yet mastered the Braille system. The participation of these students was evaluated. A multidisciplinary team consisting of architects, designers, educators, and psychologists lent support to the study. The results showed that the data collection instruments adapted to blind students were successful in making the group of authors examine questions regarding UD. An analysis of the participatory phase showed that the limitations resulting from blindness determine the specificities in the adaptation and implementation process of the instruments in schools. Practical recommendations for future studies related to instruments in the UD thematic are presented. This approach is in line with the global trend of including disabled persons in society based on these users’ opinions concerning what was designed by architects and designers.

  16. Study on 'Tannix' an absorbent for heavy metals including uranium

    International Nuclear Information System (INIS)

    Nakamura, Yasuo

    1997-01-01

    To treat radioactive wastes including uranium and transuranic elements such as plutonium, americium etc., development of an absorbent which can be used to absorb and isolate these elements without producing secondary wastes after treatment was attempted. And an absorbent has been successfully developed by polymerizing tannin, a natural product. It is known that tannin binds heavy metals including uranium resulting to produce their precipitates. There are some reports suggesting its absorption ability for uranium. However, tannin has not been used to isolate a heavy metal from a solution because it is soluble in water. Here, insolubilization of tannin was attempted and a manufacturing method for a gelatinized insoluble tannin named as ''Tannix'' was established. Wattle tannin extracted from Mimosa pudica produced in Africa was dissolved in an alkaline solution and gelatinized by heating after the addition of formalin. Thus obtained insoluble tannin was used after crushing and sieving. This product, ''Tannix'' was able to absorb more than 99% of uranium in the waste. And the absorbed Tannin could be degraded by incineration even at a low temperature, leaving only uranium, but not producing any secondary product. (M.N.)

  17. Study on `Tannix` an absorbent for heavy metals including uranium

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Yasuo [Mitsubishi Nuclear Fuel Co. Ltd., Tokyo (Japan)

    1997-09-01

    To treat radioactive wastes including uranium and transuranic elements such as plutonium, americium etc., development of an absorbent which can be used to absorb and isolate these elements without producing secondary wastes after treatment was attempted. And an absorbent has been successfully developed by polymerizing tannin, a natural product. It is known that tannin binds heavy metals including uranium resulting to produce their precipitates. There are some reports suggesting its absorption ability for uranium. However, tannin has not been used to isolate a heavy metal from a solution because it is soluble in water. Here, insolubilization of tannin was attempted and a manufacturing method for a gelatinized insoluble tannin named as ``Tannix`` was established. Wattle tannin extracted from Mimosa pudica produced in Africa was dissolved in an alkaline solution and gelatinized by heating after the addition of formalin. Thus obtained insoluble tannin was used after crushing and sieving. This product, ``Tannix`` was able to absorb more than 99% of uranium in the waste. And the absorbed Tannin could be degraded by incineration even at a low temperature, leaving only uranium, but not producing any secondary product. (M.N.)

  18. APORTACIONES DE LA INVESTIGACIÓN EUROPEA INCLUD-ED PARA LA REDUCCIÓN DEL ABANDONO ESCOLAR PREMATURO

    Directory of Open Access Journals (Sweden)

    Maria Padrós Cuxart

    2011-05-01

    Full Text Available The challenge of reducing early school leaving in Europe, with special pressure in Spain, leads to the need of evidence based educational policies and measures. This paper presents measures to prevend and reduce early school leaving that have been identified within the research Project INCLUD-ED. Strategies for inclusion and social cohesion in Europe from education. This is the research Project with a higher level and resources developed  since now  in Europe regarding school education. The identified solutions are already being addressed in documents of the European Commission, such as the recent Communication to the European Parliament "Tackiling early school leaving: a key contribution to the Europe 2020 Agenda".

  19. PASCAL for engineers: A course including OMEGASOFT PASCAL for microcomputers

    International Nuclear Information System (INIS)

    Tausch, L.A.

    1985-01-01

    These are the notes of a PASCAL course for controls engineers at CERN. The course starts with 'Standard Pascal' and includes OMEGASOFT Pascal, a powerful extension of Pascal towards real-time and systems applications. It demonstrates how a language such as Pascal, with adequate extensions for systems programming and embedded microprocessor-driven systems, can substantially increase the productivity of programmers and the reliability of their products. Also enhanced will be the legibility of the programs and their maintainability, since programming in Pascal automatically leads to autodocumentation. Simple examples show how OMEGASOFT-PASCAL can be used for efficient programming of embedded systems for real-time data acquisition and control using the MC6809 microprocessor. (orig.)

  20. Dynamic Analysis of Wind Turbines Including Soil-Structure Interaction

    DEFF Research Database (Denmark)

    Harte, M.; Basu, B.; Nielsen, Søren R.K.

    2012-01-01

    blades and includes the effect of centrifugal stiffening due to rotation. The foundation of the structure is modeled as a rigid gravity based foundation with two DOF whose movement is related to the surrounding soil by means of complex impedance functions generated using cone model. Transfer functions...... for displacement of the turbine system are obtained and the modal frequencies of the combined turbine-foundation system are estimated. Simulations are presented for the MDOF turbine structure subjected to wind loading for different soil stiffness conditions. Steady state and turbulent wind loading, developed using...... blade element momentum theory and the Kaimal spectrum, have been considered. Soil stiffness and damping properties acquired from DNV/Risø standards are used as a comparison. The soil-structure interaction is shown to affect the response of the wind turbine. This is examined in terms of the turbine...

  1. Environmental site assessments should include radon gas testing

    International Nuclear Information System (INIS)

    Nardi, M.A.

    1991-01-01

    There are two emerging influences that will require radon gas testing as part of many property transfers and most site assessments. These requirements come from lending regulators and state legislatures. Fannie Mae and others have developed environmental investigation guidelines for the purchase of environmentally contaminated real estate. These guidelines include radon gas testing for many properties. Several states have enacted laws that require environmental disclosure forms be prepared to ensure that the parties involved in certain real estate transactions are aware of the environmental liabilities that may come with the transfer of property. Indiana has recently enacted legislation that would require the disclosure of the presence of radon gas on many commercial real estate transactions. With more lenders and state governments likely to follow this trend, radon gas testing should be performed during all property transfers and site assessment to protect the parties involved from any legal liabilities

  2. Property transfer assessments should include radon gas testing

    International Nuclear Information System (INIS)

    Nardi, M.A.

    1992-01-01

    There are two emerging influences that will require radon gas testing as part of many property transfers and most environmental assessments. These requirements come from lending regulators and state legislatures and affect single family, multifamily, and commercial properties. Fannie Mae and others have developed environmental investigation guidelines for protection from long term legal liabilities in the purchase of environmentally contaminated real estate. These guidelines include radon gas testing for many properties. Several states have enacted laws that require environmental disclosure forms be prepared to ensure that the parties involved in certain real estate transactions are aware of the environmental liabilities that may come with the transfer of property. Indiana has recently enacted legislation that would require the disclosure of the presence of radon gas on many commercial real estate transactions. With more banks and state governments following this trend, radon gas testing should be performed during all property transfers and environmental assessments to protect the parties involved from any long term legal liabilities

  3. The physics of semiconductors an introduction including nanophysics and applications

    CERN Document Server

    Grundmann, Marius

    2016-01-01

    The 3rd edition of this successful textbook contains ample material for a comprehensive upper-level undergraduate or beginning graduate course, guiding readers to the point where they can choose a special topic and begin supervised research. The textbook provides a balance between essential aspects of solid-state and semiconductor physics, on the one hand, and the principles of various semiconductor devices and their applications in electronic and photonic devices, on the other. It highlights many practical aspects of semiconductors such as alloys, strain, heterostructures, nanostructures, that are necessary in modern semiconductor research but typically omitted in textbooks. Coverage also includes additional advanced topics, such as Bragg mirrors, resonators, polarized and magnetic semiconductors, nanowires, quantum dots, multi-junction solar cells, thin film transistors, carbon-based nanostructures and transparent conductive oxides. The text derives explicit formulas for many results to support better under...

  4. Benefits of including methane measurements in selection strategies.

    Science.gov (United States)

    Robinson, D L; Oddy, V H

    2016-09-01

    Estimates of genetic/phenotypic covariances and economic values for slaughter weight, growth, feed intake and efficiency, and three potential methane traits were compiled to explore the effect of incorporating methane measurements in breeding objectives for cattle and meat sheep. The cost of methane emissions was assumed to be zero (scenario A), A$476/t (based on A$14/t CO equivalent and methane's 100-yr global warming potential [GWP] of 34; scenario B), or A$2,580/t (A$30/t CO equivalent combined with methane's 20-yr GWP of 86; scenario C). Methane traits were methane yield (MY; methane production divided by feed intake based on measurements over 1 d in respiration chambers) or short-term measurements of methane production adjusted for live weight (MPadjWt) in grazing animals, e.g., 40-60 min measurements in portable accumulation chambers (PAC) on 1 or 3 occasions, or measurements for 1 wk using a GreenFeed Emissions Monitor (GEM) on 1 or 3 occasions. Feed costs included the cost of maintaining the breeding herd and growth from weaning to slaughter. Sheep were assumed to be grown and finished on pasture (A$50/t DM). Feed costs for cattle included 365 d on pasture for the breeding herd and averages of 200 d postweaning grow-out on pasture and 100 d feedlot finishing. The greatest benefit of including methane in the breeding objective for both sheep and cattle was as a proxy for feed intake. For cattle, 3 GEM measurements were estimated to increase profit from 1 round of selection in scenario A (no payment for methane) by A$6.24/animal (from A$20.69 to A$26.93) because of reduced feed costs relative to gains in slaughter weight and by A$7.16 and A$12.09/animal, respectively, for scenarios B and C, which have payments for reduced methane emissions. For sheep, the improvements were more modest. Returns from 1 round of selection (no methane measurements) were A$5.06 (scenario A), A$4.85 (scenario B), and A$3.89 (scenario C) compared to A$5.26 (scenario A), A$5

  5. PROPERTIES AND MICROSTRUCTURE OF CEMENT PASTE INCLUDING RECYCLED CONCRETE POWDER

    Directory of Open Access Journals (Sweden)

    Jaroslav Topič

    2017-02-01

    Full Text Available The disposal and further recycling of concrete is being investigated worldwide, because the issue of complete recycling has not yet been fully resolved. A fundamental difficulty faced by researchers is the reuse of the recycled concrete fines which are very small (< 1 mm. Currently, full recycling of such waste fine fractions is highly energy intensive and resulting in production of CO2. Because of this, the only recycling methods that can be considered as sustainable and environmentally friendly are those which involve recycled concrete powder (RCP in its raw form. This article investigates the performance of RCP with the grain size < 0.25 mm as a potential binder replacement, and also as a microfiller in cement-based composites. Here, the RCP properties are assessed, including how mechanical properties and the microstructure are influenced by increasing the amount of the RCP in a cement paste (≤ 25 wt%.

  6. Ball Screw Actuator Including a Compliant Ball Screw Stop

    Science.gov (United States)

    Wingett, Paul T. (Inventor); Hanlon, Casey (Inventor)

    2017-01-01

    An actuator includes a ball nut, a ball screw, and a ball screw stop. The ball nut is adapted to receive an input torque and in response rotates and supplies a drive force. The ball screw extends through the ball nut and has a first end and a second end. The ball screw receives the drive force from the ball nut and in response selectively translates between a retract position and a extend position. The ball screw stop is mounted on the ball screw proximate the first end to translate therewith. The ball screw stop engages the ball nut when the ball screw is in the extend position, translates, with compliance, a predetermined distance toward the first end upon engaging the ball nut, and prevents further rotation of the ball screw upon translating the predetermined distance.

  7. Ball Screw Actuator Including a Stop with an Integral Guide

    Science.gov (United States)

    Wingett, Paul T. (Inventor); Perek, John (Inventor); Geck, Kellan (Inventor)

    2015-01-01

    An actuator includes a housing assembly, a ball nut, a ball screw, and a ball screw stop. The ball nut is rotationally mounted in the housing assembly, is adapted to receive an input torque, and is configured, upon receipt thereof, to rotate and supply a drive force. The ball screw is mounted within the housing assembly and extends through the ball nut. The ball screw has a first end and a second end, and is coupled to receive the drive force from the ball nut. The ball screw is configured, upon receipt of the drive force, to selectively translate between a stow position and a deploy position. The ball screw stop is mounted on the ball screw to translate therewith and is configured to at selectively engage the housing assembly while the ball screw is translating, and engage the ball nut when the ball screw is in the deploy position.

  8. Ball Screw Actuator Including an Axial Soft Stop

    Science.gov (United States)

    Wingett, Paul T. (Inventor); Forrest, Steven Talbert (Inventor); Abel, Steve (Inventor); Woessner, George (Inventor); Hanlon, Casey (Inventor)

    2016-01-01

    An actuator includes an actuator housing, a ball screw, and an axial soft stop assembly. The ball screw extends through the actuator housing and has a first end and a second end. The ball screw is coupled to receive a drive force and is configured, upon receipt of the drive force, to selectively move in a retract direction and an extend direction. The axial soft stop assembly is disposed within the actuator housing. The axial soft stop assembly is configured to be selectively engaged by the ball screw and, upon being engaged thereby, to translate, with compliance, a predetermined distance in the extend direction, and to prevent further movement of the ball screw upon translating the predetermined distance.

  9. The Physics of Semiconductors An Introduction Including Nanophysics and Applications

    CERN Document Server

    Grundmann, Marius

    2010-01-01

    The Physics of Semiconductors contains ample material for a comprehensive upper-level undergraduate or beginning graduate course, guiding readers to the point where they can choose a special topic and begin supervised research. The textbook provides a balance between essential aspects of solid-state and semiconductor physics, on the one hand, and the principles of various semiconductor devices and their applications in electronic and photonic devices, on the other. It highlights many practical aspects of semiconductors such as alloys, strain, heterostructures, nanostructures, that are necessary in modern semiconductor research but typically omitted in textbooks. Coverage also includes additional advanced topics, such as Bragg mirrors, resonators, polarized and magnetic semiconductors. The text derives explicit formulas for many results to support better understanding of the topics. The Physics of Semiconductors requires little or no prior knowledge of solid-state physics and evolved from a highly regarded two...

  10. Relativistic bound state approach to fundamental forces including gravitation

    Directory of Open Access Journals (Sweden)

    Morsch H.P.

    2012-06-01

    Full Text Available To describe the structure of particle bound states of nature, a relativistic bound state formalism is presented, which requires a Lagrangian including scalar coupling of two boson fields. The underlying mechanisms are quite complex and require an interplay of overlapping boson fields and fermion-antifermion production. This gives rise to two potentials, a boson-exchange potential and one identified with the long sought confinement potential in hadrons. With minimal requirements, two elementary massless fermions (quantons - with and without charge - and one gauge boson, hadrons and leptons but also atoms and gravitational systems are described by bound states with electric and magnetic coupling between the charges and spins of quantons. No need is found for colour, Higgs-coupling and supersymmetry.

  11. Assessing bias in osteoarthritis trials included in Cochrane reviews

    DEFF Research Database (Denmark)

    Hansen, Julie Bolvig; Juhl, Carsten Bogh; Boutron, Isabelle

    2014-01-01

    the first appearing forest plot for overall pain in the Cochrane review. Treatment effect sizes will be expressed as standardised mean differences (SMDs), where the difference in mean values available from the forest plots is divided by the pooled SD. To empirically assess the risk of bias in treatment......INTRODUCTION: The validity of systematic reviews and meta-analysis depends on methodological quality and unbiased dissemination of trials. Our objective is to evaluate the association of estimates of treatment effects with different bias-related study characteristics in meta...... benefits, we will perform stratified analyses of the trials from the included meta-analyses and assess the interaction between trial characteristics and treatment effect. A relevant study-level covariate is defined as one that decreases the between-study variance (τ(2), estimated as Tau...

  12. Two-dimensional analysis of motion artifacts, including flow effects

    International Nuclear Information System (INIS)

    Litt, A.M.; Brody, A.S.; Spangler, R.A.; Scott, P.D.

    1990-01-01

    The effects of motion on magnetic resonance images have been theoretically analyzed for the case of a point-like object in simple harmonic motion and for other one-dimensional trajectories. The authors of this paper extend this analysis to a generalized two-dimensional magnetization with an arbitrary motion trajectory. The authors provide specific solutions for the clinically relevant cases of the cross-sections of cylindrical objects in the body, such as the aorta, which has a roughly one-dimensional, simple harmonic motion during respiration. By extending the solution to include inhomogeneous magnetizations, the authors present a model which allows the effects of motion artifacts and flow artifacts to be analyzed simultaneously

  13. Neutrinos from Cosmic Accelerators including Magnetic Field and Flavor Effects

    Directory of Open Access Journals (Sweden)

    Walter Winter

    2012-01-01

    Full Text Available We review the particle physics ingredients affecting the normalization, shape, and flavor composition of astrophysical neutrinos fluxes, such as different production modes, magnetic field effects on the secondaries (muons, pions, and kaons, and flavor mixing, where we focus on pγ interactions. We also discuss the interplay with neutrino propagation and detection, including the possibility to detect flavor and its application in particle physics, and the use of the Glashow resonance to discriminate pγ from pp interactions in the source. We illustrate the implications on fluxes and flavor composition with two different models: (1 the target photon spectrum is dominated by synchrotron emission of coaccelerated electrons and (2 the target photon spectrum follows the observed photon spectrum of gamma-ray bursts. In the latter case, the multimessenger extrapolation from the gamma-ray fluence to the expected neutrino flux is highlighted.

  14. Optimage central organised image quality control including statistics and reporting

    International Nuclear Information System (INIS)

    Jahnen, A.; Schilz, C.; Shannoun, F.; Schreiner, A.; Hermen, J.; Moll, C.

    2008-01-01

    Quality control of medical imaging systems is performed using dedicated phantoms. As the imaging systems are more and more digital, adequate image processing methods might help to save evaluation time and to receive objective results. The developed software package OPTIMAGE is focusing on this with a central approach: On one hand, OPTIMAGE provides a framework, which includes functions like database integration, DICOM data sources, multilingual user interface and image processing functionality. On the other hand, the test methods are implemented using modules which are able to process the images automatically for the common imaging systems. The integration of statistics and reporting into this environment is paramount: This is the only way to provide these functions in an interactive, user-friendly way. These features enable the users to discover degradation in performance quickly and document performed measurements easily. (authors)

  15. A Case for Including Transactions in OpenMP

    Energy Technology Data Exchange (ETDEWEB)

    Wong, M; Bihari, B L; de Supinski, B R; Wu, P; Michael, M; Liu, Y; Chen, W

    2010-01-25

    Transactional Memory (TM) has received significant attention recently as a mechanism to reduce the complexity of shared memory programming. We explore the potential of TM to improve OpenMP applications. We combine a software TM (STM) system to support transactions with an OpenMP implementation to start thread teams and provide task and loop-level parallelization. We apply this system to two application scenarios that reflect realistic TM use cases. Our results with this system demonstrate that even with the relatively high overheads of STM, transactions can outperform OpenMP critical sections by 10%. Overall, our study demonstrates that extending OpenMP to include transactions would ease programming effort while allowing improved performance.

  16. Actuator assembly including a single axis of rotation locking member

    Science.gov (United States)

    Quitmeyer, James N.; Benson, Dwayne M.; Geck, Kellan P.

    2009-12-08

    An actuator assembly including an actuator housing assembly and a single axis of rotation locking member fixedly attached to a portion of the actuator housing assembly and an external mounting structure. The single axis of rotation locking member restricting rotational movement of the actuator housing assembly about at least one axis. The single axis of rotation locking member is coupled at a first end to the actuator housing assembly about a Y axis and at a 90.degree. angle to an X and Z axis providing rotation of the actuator housing assembly about the Y axis. The single axis of rotation locking member is coupled at a second end to a mounting structure, and more particularly a mounting pin, about an X axis and at a 90.degree. angle to a Y and Z axis providing rotation of the actuator housing assembly about the X axis. The actuator assembly is thereby restricted from rotation about the Z axis.

  17. Double-photoionization of helium including quadrupole radiation effects

    Energy Technology Data Exchange (ETDEWEB)

    Colgan, James [Los Alamos National Laboratory; Ludlow, J A [AUBURN UNIV; Lee, Teck - Ghee [AUBURN UNIV; Pindzola, M S [AUBURN UNIV; Robicheaux, F [AUBURN UNIV

    2009-01-01

    Non-perturbative time-dependent close-coupling calculations are carried out for the double photoionization of helium including both dipole and quadrupole radiation effects. At a photon energy of 800 eV, accessible at CUlTent synchrotron light sources, the quadrupole interaction contributes around 6% to the total integral double photoionization cross section. The pure quadrupole single energy differential cross section shows a local maxima at equal energy sharing, as opposed to the minimum found in the pure dipole single energy differential cross section. The sum of the pure dipole and pure quadrupole single energy differentials is insensitive to non-dipole effects at 800 eV. However, the triple differential cross section at equal energy sharing of the two ejected electrons shows strong non-dipole effects due to the quadrupole interaction that may be experimentally observable.

  18. Loan Products Included in the Offer of Commercial Banks

    Directory of Open Access Journals (Sweden)

    Vasile Dedu

    2009-04-01

    Full Text Available A bank loan is the main form of economical credit. It is for corporate activities – for medium and big companies and for retail activities – for small companies and individuals. The conditions for credit mainly depend on the quality of customers, it means their ability to perform a profitable activity and to be able to pay back the credits. For reasons which are mainly connected to marketing, bank practice has developed a large range of credit names, trying to emphasize some of the parts of the products or to take profit of some competition advantages in relation with customers’ products. We are trying to include the offer of bank loans in a typology which takes into account the law, the bank field rules and the main technical features of the offered products.

  19. Terrorism cover in France for property damage including nuclear risks

    International Nuclear Information System (INIS)

    Stanislas, A.

    2004-01-01

    The obligation to include terrorism cover in all Property Damage policies issued on the French Market is ruled by an Act of 1986 and introduced under Section R 126-2 of the French Code of Insurance. This section stipulates that Property Damage policies must provide cover for damage resulting from acts of terrorism, with the same deductible and the same limit than that of the other damage covered in the policy. Soon after the dramatic events of September 11, 2001 in the United States and although reinsurers worldwide restricted their offer of capacities, French insurers recognized that they had to maintain this global cover for the benefit of their insurers. After difficult discussions between insurers, reinsurers, brokers, risk managers and representatives of the State, the creation of a new Pool, backed with a State guarantee, was decided in less than three months. Effective January 1, 2002 and called Gestion d'Assurance et de Reassurance des Risques Attentats et Actes de Terrorisme (GAREAT), the Pool offers a multiple layers stop-loss cover for Property Damage only, i.e. excluding TPL policies. Considering that nuclear risks should be treated in the same way as other industrial risks, it was decided that they would be covered by GAREAT as well. In the meantime, by a Decree of December 28, 2001 modifying Section R 126-2, a special provision, aiming at reducing the limit and thus the price of this cover, was introduced in the Code. The purpose of this paper is to expose the present situation applying through GAREAT and, after two years of operation to discuss future developments, including other sources of capacity for the coverage of acts of terrorism in nuclear risks insurance.(author)

  20. Including a learner with physical disabilities: stressful for teachers?

    Directory of Open Access Journals (Sweden)

    I. Eloff

    2002-08-01

    Full Text Available Learners with physical disabilities have been entering mainstream schools for some years now. Whereas early research on inclusive education necessitated a strong focus on the needs of the learners, there has also been a recent interest in the role of the teachers in inclusive education. By adopting constructivism as the paradigm for inquiry a study was undertaken to establish the stress factors for teachers who have to include a learner with a physical disability in their mainstream classes. The rationale for the study is threefold: i Learners with physical disabilities are entering mainstream schools increasingly, ii it is often assumed that inclusive education is too stressful for teachers to cope with, and iii related research has shown that increased contact with individuals with disabilities has a positive effect on attitudes towards individuals with disabilities. In accordance with the dialectical methodology of constructivism, the Teacher Stress and Coping Questionnaire and in-depth interviews were utilised to establish the stress factors and the extent of the stress factors that may be present. The aim of the constructivist inquiry process is to promote understanding and reconstruction. In this article the quantitative results indicate overall low or non-existent levels of stress in teachers who have to include a learner with a physical disability, and the results therefore contribute to our understanding of this situation. The qualitative results reconstruct the meanings that these teachers attach to the inclusion of a learner with a physical disability and reveal some albeit limited concerns about the communication processes between parents and teachers and a perceived lack of pre-service training.

  1. 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.

  2. Strategies for replacement of obsolete equipment, including reverse engineering

    International Nuclear Information System (INIS)

    Irish, C.S.

    2003-01-01

    The presentation shall detail the challenges facing nuclear power plants with the replacement of obsolete equipment and the strategies used to overcome those challenges. The presentation will outline the common equipment types which are either obsolete or are becoming obsolete, with a focus on safety related components. The four options of the obsolete equipment replacement philosophy will be presented with replacement examples from each of the options shown for discussion purposes. Detailed examples from each of the four obsolete equipment replacement options of, (1) commercially available equivalent component, (2) modification of a commercial available component, (3) reverse engineering of the original component and finally (4) design changes using a new component, shall be presented to evaluate the advantages and disadvantages of each option. The presentation will include the technical challenges, cost and schedule concerns for each of the four options. Emphasis will be placed on the technological challenges associated with replacing old and obsolete equipment. The following is a bullet list of the challenges which will be discussed: 1) Missing, misleading or no information on the original component. 2) Acquiring information from the original equipment manufacturer and the plant. 3) Using a sample component for the replacement evaluation and or reverse engineering. 4) Reverse engineering old equipment with newly available discrete components. The presentation will include the equivalency documentation using the EPRI guidelines when replacing an original component with a different yet form, fit and functional equivalent component. The presentation will conclude with a discussion of the advantages and disadvantages of the replacement of the obsolete component with a form, fit and functional equivalent component vs. the replacement of the original component with a new component with today's technology. (author)

  3. Strategies for replacement of obsolete equipment - including reverse engineering

    International Nuclear Information System (INIS)

    Irish, C.S.

    2000-01-01

    The presentation shall detail the challenges facing nuclear power plants with the replacement of obsolete equipment and the strategies used to overcome those challenges. The presentation will outline the common equipment types which are either obsolete or are becoming obsolete, with a focus on safety related components. The four options of the obsolete equipment replacement philosophy will be presented with replacement examples from each of the options shown for discussion purposes. Detailed examples from each of the four obsolete equipment replacement options of: commercially available equivalent component; modification of a commercial available component; reverse engineering of the original component; and finally, design changes using a new component, shall be presented to evaluate the advantages and disadvantages of each option. The presentation will include the technical challenges, cost and schedule concerns for each of the four options. Emphasis will be placed on the technological challenges associated with replacing old and obsolete equipment. The following is a bullet list of the challenges which will be discussed: Missing, misleading or no information on the original component; Acquiring information from the original equipment manufacturer and the plant; Using a sample component for the replacement evaluation and or reverse engineering; and Reverse engineering old equipment with newly available discrete components. The presentation will include the equivalency documentation using the EPRI guidelines when replacing an original component with a different yet form, fit and functional equivalent component. The presentation will conclude with a discussion of the advantages and disadvantages of the replacement of the obsolete component with a form, fit and functional equivalent component vs. the replacement of the original component with a new component with today's technology. (author)

  4. Solving the high energy evolution equation including running coupling corrections

    International Nuclear Information System (INIS)

    Albacete, Javier L.; Kovchegov, Yuri V.

    2007-01-01

    We study the solution of the nonlinear Balitsky-Kovchegov evolution equation with the recently calculated running coupling corrections [I. I. Balitsky, Phys. Rev. D 75, 014001 (2007). and Y. Kovchegov and H. Weigert, Nucl. Phys. A784, 188 (2007).]. Performing a numerical solution we confirm the earlier result of Albacete et al. [Phys. Rev. D 71, 014003 (2005).] (obtained by exploring several possible scales for the running coupling) that the high energy evolution with the running coupling leads to a universal scaling behavior for the dipole-nucleus scattering amplitude, which is independent of the initial conditions. It is important to stress that the running coupling corrections calculated recently significantly change the shape of the scaling function as compared to the fixed coupling case, in particular, leading to a considerable increase in the anomalous dimension and to a slow-down of the evolution with rapidity. We then concentrate on elucidating the differences between the two recent calculations of the running coupling corrections. We explain that the difference is due to an extra contribution to the evolution kernel, referred to as the subtraction term, which arises when running coupling corrections are included. These subtraction terms were neglected in both recent calculations. We evaluate numerically the subtraction terms for both calculations, and demonstrate that when the subtraction terms are added back to the evolution kernels obtained in the two works the resulting dipole amplitudes agree with each other. We then use the complete running coupling kernel including the subtraction term to find the numerical solution of the resulting full nonlinear evolution equation with the running coupling corrections. Again the scaling regime is recovered at very large rapidity with the scaling function unaltered by the subtraction term

  5. Extending Vulnerability Assessment to Include Life Stages Considerations.

    Science.gov (United States)

    Hodgson, Emma E; Essington, Timothy E; Kaplan, Isaac C

    2016-01-01

    Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill-Euphausia pacifica and Thysanoessa spinifera, pteropod-Limacina helicina, pink shrimp-Pandalus jordani, Dungeness crab-Metacarcinus magister and Pacific hake-Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species' vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate.

  6. STXBP1 encephalopathy: A neurodevelopmental disorder including epilepsy.

    Science.gov (United States)

    Stamberger, Hannah; Nikanorova, Marina; Willemsen, Marjolein H; Accorsi, Patrizia; Angriman, Marco; Baier, Hartmut; Benkel-Herrenbrueck, Ira; Benoit, Valérie; Budetta, Mauro; Caliebe, Almuth; Cantalupo, Gaetano; Capovilla, Giuseppe; Casara, Gianluca; Courage, Carolina; Deprez, Marie; Destrée, Anne; Dilena, Robertino; Erasmus, Corrie E; Fannemel, Madeleine; Fjær, Roar; Giordano, Lucio; Helbig, Katherine L; Heyne, Henrike O; Klepper, Joerg; Kluger, Gerhard J; Lederer, Damien; Lodi, Monica; Maier, Oliver; Merkenschlager, Andreas; Michelberger, Nina; Minetti, Carlo; Muhle, Hiltrud; Phalin, Judith; Ramsey, Keri; Romeo, Antonino; Schallner, Jens; Schanze, Ina; Shinawi, Marwan; Sleegers, Kristel; Sterbova, Katalin; Syrbe, Steffen; Traverso, Monica; Tzschach, Andreas; Uldall, Peter; Van Coster, Rudy; Verhelst, Helene; Viri, Maurizio; Winter, Susan; Wolff, Markus; Zenker, Martin; Zoccante, Leonardo; De Jonghe, Peter; Helbig, Ingo; Striano, Pasquale; Lemke, Johannes R; Møller, Rikke S; Weckhuysen, Sarah

    2016-03-08

    To give a comprehensive overview of the phenotypic and genetic spectrum of STXBP1 encephalopathy (STXBP1-E) by systematically reviewing newly diagnosed and previously reported patients. We recruited newly diagnosed patients with STXBP1 mutations through an international network of clinicians and geneticists. Furthermore, we performed a systematic literature search to review the phenotypes of all previously reported patients. We describe the phenotypic features of 147 patients with STXBP1-E including 45 previously unreported patients with 33 novel STXBP1 mutations. All patients have intellectual disability (ID), which is mostly severe to profound (88%). Ninety-five percent of patients have epilepsy. While one-third of patients presented with Ohtahara syndrome (21%) or West syndrome (9.5%), the majority has a nonsyndromic early-onset epilepsy and encephalopathy (53%) with epileptic spasms or tonic seizures as main seizure type. We found no correlation between severity of seizures and severity of ID or between mutation type and seizure characteristics or cognitive outcome. Neurologic comorbidities including autistic features and movement disorders are frequent. We also report 2 previously unreported adult patients with prominent extrapyramidal features. De novo STXBP1 mutations are among the most frequent causes of epilepsy and encephalopathy. Most patients have severe to profound ID with little correlation among seizure onset, seizure severity, and the degree of ID. Accordingly, we hypothesize that seizure severity and ID present 2 independent dimensions of the STXBP1-E phenotype. STXBP1-E may be conceptualized as a complex neurodevelopmental disorder rather than a primary epileptic encephalopathy. © 2016 American Academy of Neurology.

  7. Universal health coverage in 'One ASEAN': are migrants included?

    Science.gov (United States)

    Guinto, Ramon Lorenzo Luis R; Curran, Ufara Zuwasti; Suphanchaimat, Rapeepong; Pocock, Nicola S

    2015-01-01

    As the Association of South East Asian Nations (ASEAN) gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC) reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as they redefine UHC beyond the basis of

  8. Magnetic properties of nickel halide hydrates including deuteration effects

    Energy Technology Data Exchange (ETDEWEB)

    DeFotis, G.C., E-mail: gxdefo@wm.edu [Chemistry Department, College of William & Mary, Williamsburg, VA, 23187 United States (United States); Van Dongen, M.J.; Hampton, A.S.; Komatsu, C.H.; Trowell, K.T.; Havas, K.C.; Davis, C.M.; DeSanto, C.L. [Chemistry Department, College of William & Mary, Williamsburg, VA, 23187 United States (United States); Hays, K.; Wagner, M.J. [Chemistry Department, George Washington University, Washington, DC, 20052 United States (United States)

    2017-01-01

    Magnetic measurements on variously hydrated nickel chlorides and bromides, including deuterated forms, are reported. Results include locations and sizes of susceptibility maxima, T{sub max} and χ{sub max}, ordering temperatures T{sub c}, Curie constants and Weiss theta in the paramagnetic regime, and primary and secondary exchange interactions from analysis of low temperature data. For the latter a 2D Heisenberg model augmented by interlayer exchange in a mean-field approximation is applied. Magnetization data to 16 kG as a function of temperature show curvature and hysteresis characteristics quite system dependent. For four materials high field magnetization data to 70 kG at 2.00 K are also obtained. Comparison is made with theoretical relations for spin-1 models. Trends are apparent, primarily that T{sub max} of each bromide hydrate is less than for the corresponding chloride, and that for a given halide nD{sub 2}O (n=1 or 2) deuterates exhibit lesser T{sub max} than do nH{sub 2}O hydrates. A monoclinic unit cell determined from powder X-ray diffraction data on NiBr{sub 2}·2D{sub 2}O is different from and slightly larger than that of NiBr{sub 2}·2H{sub 2}O. This provides some rationale for the difference in magnetic properties between these. - Highlights: • The magnetism of Ni(II) chloride and bromide dihydrates and monohydrates is studied. • Effects of replacing H{sub 2}O by D{sub 2}O are examined for both hydration states and both halides. • Exchange interactions in bromides are weaker than in corresponding chlorides. • Exchange interactions are weaker in D{sub 2}O than in corresponding H{sub 2}O containing systems. • The unit cell of NiBr{sub 2}·2D{sub 2}O is different from and slightly larger than that of NiBr{sub 2}·2H{sub 2}O.

  9. Including geological information in the inverse problem of palaeothermal reconstruction

    Science.gov (United States)

    Trautner, S.; Nielsen, S. B.

    2003-04-01

    A reliable reconstruction of sediment thermal history is of central importance to the assessment of hydrocarbon potential and the understanding of basin evolution. However, only rarely do sedimentation history and borehole data in the form of present day temperatures and vitrinite reflectance constrain the past thermal evolution to a useful level of accuracy (Gallagher and Sambridge,1992; Nielsen,1998; Trautner and Nielsen,2003). This is reflected in the inverse solutions to the problem of determining heat flow history from borehole data: The recent heat flow is constrained by data while older values are governed by the chosen a prior heat flow. In this paper we reduce this problem by including geological information in the inverse problem. Through a careful analysis of geological and geophysical data the timing of the tectonic processes, which may influence heat flow, can be inferred. The heat flow history is then parameterised to allow for the temporal variations characteristic of the different tectonic events. The inversion scheme applies a Markov chain Monte Carlo (MCMC) approach (Nielsen and Gallagher, 1999; Ferrero and Gallagher,2002), which efficiently explores the model space and futhermore samples the posterior probability distribution of the model. The technique is demonstrated on wells in the northern North Sea with emphasis on the stretching event in Late Jurassic. The wells are characterised by maximum sediment temperature at the present day, which is the worst case for resolution of the past thermal history because vitrinite reflectance is determined mainly by the maximum temperature. Including geological information significantly improves the thermal resolution. Ferrero, C. and Gallagher,K.,2002. Stochastic thermal history modelling.1. Constraining heat flow histories and their uncertainty. Marine and Petroleum Geology, 19, 633-648. Gallagher,K. and Sambridge, M., 1992. The resolution of past heat flow in sedimentary basins from non-linear inversion

  10. The protean nature of Whipple's disease includes multiorgan arteriopathy.

    Science.gov (United States)

    James, T N

    2001-01-01

    Knowledge about the arterial abnormalities in Whipple's disease can be useful for our better understanding of both Whipple's disease and the more general question of pathogenesis of atherosclerosis. There are several notable morphological features of Whipple's arteriopathy. First, it appears to involve primarily arteries one millimeter or less in diameter. Second, there is very little evidence of inflammation accompanying invasion of any or all three layers of the walls of affected arteries, and there is almost no evidence of local attraction of platelets to these sites of arterial injury. Third, the nature of arterial injury appears to be one of slow progression. The few sites of actual arteritis are most likely attributable to some other coinciding microbial organism not yet identified. Although the arteriopathy in Whipple's disease is seen mainly in small arteries (the aorta is a notable exception), their significance can be illustrated by consideration of this fact as it applies to the coronary circulation (and probably the arteries of all other organs). In the heart these small arteries comprise almost the entire collateral circulation, the principal blood supply to each component of the conduction system, and most pragmatically, these small arteries represent the terminal distribution of every larger epicardial artery. Small arteries are important. The "cardiomyopathy" so often a feature of Whipple's disease (very much including his original case) is most logically attributable to recurring bouts of focal ischemia and subsequent focal fibrosis ending in myocardial incompetence. However, direct bacillary invasion of cardiac myocytes (22) also occurs. In lamina propria of jejunum, there is also arteriopathy, as there is in brain, lung, kidney, spleen, liver, gall bladder, rectum, stomach, lymph nodes and testis. It is likely that no organ in the body is spared. There is growing evidence that a wide variety of chronic infections (occurring concomitantly or

  11. Designing monitoring programs for chemicals of emerging concern in potable reuse ⋯ What to include and what not to include?

    KAUST Repository

    Drewes, Jorg

    2012-11-01

    This study discussed a proposed process to prioritize chemicals for reclaimed water monitoring programs, selection of analytical methods required for their quantification, toxicological relevance of chemicals of emerging concern regarding human health, and related issues. Given that thousands of chemicals are potentially present in reclaimed water and that information about those chemicals is rapidly evolving, a transparent, science-based framework was developed to guide prioritization of which compounds of emerging concern (CECs) should be included in reclaimed water monitoring programs. The recommended framework includes four steps: (1) compile environmental concentrations (e.g., measured environmental concentration or MEC) of CECs in the source water for reuse projects; (2) develop a monitoring trigger level (MTL) for each of these compounds (or groups thereof) based on toxicological relevance; (3) compare the environmental concentration (e.g., MEC) to the MTL; CECs with a MEC/MTL ratio greater than 1 should be prioritized for monitoring, compounds with a ratio less than \\'1\\' should only be considered if they represent viable treatment process performance indicators; and (4) screen the priority list to ensure that a commercially available robust analytical method is available for that compound. © IWA Publishing 2013.

  12. A hydrodynamic model for granular material flows including segregation effects

    Directory of Open Access Journals (Sweden)

    Gilberg Dominik

    2017-01-01

    Full Text Available The simulation of granular flows including segregation effects in large industrial processes using particle methods is accurate, but very time-consuming. To overcome the long computation times a macroscopic model is a natural choice. Therefore, we couple a mixture theory based segregation model to a hydrodynamic model of Navier-Stokes-type, describing the flow behavior of the granular material. The granular flow model is a hybrid model derived from kinetic theory and a soil mechanical approach to cover the regime of fast dilute flow, as well as slow dense flow, where the density of the granular material is close to the maximum packing density. Originally, the segregation model has been formulated by Thornton and Gray for idealized avalanches. It is modified and adapted to be in the preferred form for the coupling. In the final coupled model the segregation process depends on the local state of the granular system. On the other hand, the granular system changes as differently mixed regions of the granular material differ i.e. in the packing density. For the modeling process the focus lies on dry granular material flows of two particle types differing only in size but can be easily extended to arbitrary granular mixtures of different particle size and density. To solve the coupled system a finite volume approach is used. To test the model the rotational mixing of small and large particles in a tumbler is simulated.

  13. Understanding type 2 diabetes: including the family member's perspective.

    LENUS (Irish Health Repository)

    White, Patricia

    2012-02-01

    PURPOSE: The purpose of this study was to examine the relationship between psychological and social factors and diabetes outcomes in people with type 2 diabetes and their family members. METHODS: A total of 153 patients with type 2 diabetes were assessed at a diabetes outpatient clinic and postal questionnaires were sent to nominated family members. The measures examined were diabetes knowledge, social support, well-being, and illness perceptions. RESULTS: When compared with those with diabetes, family members reported lower positive well-being and lower levels of satisfaction with support. They also perceived diabetes as a more cyclical illness, which was controlled more by treatment than by the individual. Family members also reported that the person with diabetes was more emotionally distressed and knew more about diabetes than the patient had actually reported himself or herself. There were no differences between the family members of those in good or poor glycaemic control. CONCLUSIONS: This study reinforces the importance of understanding social context and illness beliefs in diabetes management. It also highlights the potential for including family members in discussions and education about diabetes management.

  14. Advanced methodology for generation expansion planning including interconnected systems

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, M.; Yokoyama, R.; Yasuda, K. [Tokyo Metropolitan Univ. (Japan); Sasaki, H. [Hiroshima Univ. (Japan); Ogimoto, K. [Electric Power Development Co. Ltd., Tokyo (Japan)

    1994-12-31

    This paper reviews advanced methodology for generation expansion planning including interconnected systems developed in Japan, putting focus on flexibility and efficiency in a practical application. First, criteria for evaluating flexibility of generation planning considering uncertainties are introduced. Secondly, the flexible generation mix problem is formulated as a multi-objective optimization with more than two objective functions. The multi-objective optimization problem is then transformed into a single objective problem by using the weighting method, to obtain the Pareto optimal solution, and solved by a dynamics programming technique. Thirdly, a new approach for electric generation expansion planning of interconnected systems is presented, based on the Benders Decomposition technique. That is, large scale generation problem constituted by the general economic load dispatch problem, and several sub problems which are composed of smaller scale isolated system generation expansion plans. Finally, the generation expansion plan solved by an artificial neural network is presented. In conclusion, the advantages and disadvantages of this method from the viewpoint of flexibility and applicability to practical generation expansion planning are presented. (author) 29 refs., 10 figs., 4 tabs.

  15. Interim performance criteria for photovoltaic energy systems. [Glossary included

    Energy Technology Data Exchange (ETDEWEB)

    DeBlasio, R.; Forman, S.; Hogan, S.; Nuss, G.; Post, H.; Ross, R.; Schafft, H.

    1980-12-01

    This document is a response to the Photovoltaic Research, Development, and Demonstration Act of 1978 (P.L. 95-590) which required the generation of performance criteria for photovoltaic energy systems. Since the document is evolutionary and will be updated, the term interim is used. More than 50 experts in the photovoltaic field have contributed in the writing and review of the 179 performance criteria listed in this document. The performance criteria address characteristics of present-day photovoltaic systems that are of interest to manufacturers, government agencies, purchasers, and all others interested in various aspects of photovoltaic system performance and safety. The performance criteria apply to the system as a whole and to its possible subsystems: array, power conditioning, monitor and control, storage, cabling, and power distribution. They are further categorized according to the following performance attributes: electrical, thermal, mechanical/structural, safety, durability/reliability, installation/operation/maintenance, and building/site. Each criterion contains a statement of expected performance (nonprescriptive), a method of evaluation, and a commentary with further information or justification. Over 50 references for background information are also given. A glossary with definitions relevant to photovoltaic systems and a section on test methods are presented in the appendices. Twenty test methods are included to measure performance characteristics of the subsystem elements. These test methods and other parts of the document will be expanded or revised as future experience and needs dictate.

  16. Polycrystalline-Diamond MEMS Biosensors Including Neural Microelectrode-Arrays

    Directory of Open Access Journals (Sweden)

    Donna H. Wang

    2011-08-01

    Full Text Available Diamond is a material of interest due to its unique combination of properties, including its chemical inertness and biocompatibility. Polycrystalline diamond (poly-C has been used in experimental biosensors that utilize electrochemical methods and antigen-antibody binding for the detection of biological molecules. Boron-doped poly-C electrodes have been found to be very advantageous for electrochemical applications due to their large potential window, low background current and noise, and low detection limits (as low as 500 fM. The biocompatibility of poly-C is found to be comparable, or superior to, other materials commonly used for implants, such as titanium and 316 stainless steel. We have developed a diamond-based, neural microelectrode-array (MEA, due to the desirability of poly-C as a biosensor. These diamond probes have been used for in vivo electrical recording and in vitro electrochemical detection. Poly-C electrodes have been used for electrical recording of neural activity. In vitro studies indicate that the diamond probe can detect norepinephrine at a 5 nM level. We propose a combination of diamond micro-machining and surface functionalization for manufacturing diamond pathogen-microsensors.

  17. Falling vertical chain of oscillators, including collisions, damping, and pretensioning

    Science.gov (United States)

    Plaut, R. H.; Borum, A. D.; Holmes, D. P.; Dillard, D. A.

    2015-08-01

    A chain of point masses connected by linear springs and sometimes dashpots is considered. The chain hangs in a vertical equilibrium configuration, held by its top mass. Then the top mass is released, and the chain falls. Internal damping, modeled by the dashpots, causes the bottom mass to move faster. As the system falls, upper masses sometimes accelerate faster than gravitational acceleration, and collisions may occur between adjacent masses. The types of collisions treated here include elastic, inelastic, and perfectly inelastic (in which colliding masses often stick together thereafter). The unstretched lengths of the springs, and a compressive force caused by pretensioning, may significantly affect the characteristics of the motion. Analytical and numerical results are presented for cases involving a few masses, and some generalizations are made for systems with an arbitrary number of masses. Also, the vertical chain may be used to model the motion of a falling Slinky after release at its top end. The bottom of the continuous Slinky does not move until the coils above it have collapsed onto it, and the collapse time is estimated here using the discrete chain model. For a metal Slinky with 86 masses, the estimated time is close to that previously obtained by a continuous elastic analysis.

  18. Cosmological constraints on the neutrino mass including systematic uncertainties

    Science.gov (United States)

    Couchot, F.; Henrot-Versillé, S.; Perdereau, O.; Plaszczynski, S.; Rouillé d'Orfeuil, B.; Spinelli, M.; Tristram, M.

    2017-10-01

    When combining cosmological and oscillations results to constrain the neutrino sector, the question of the propagation of systematic uncertainties is often raised. We address this issue in the context of the derivation of an upper bound on the sum of the neutrino masses (Σmν) with recent cosmological data. This work is performed within the ΛCDM model extended to Σmν, for which we advocate the use of three mass-degenerate neutrinos. We focus on the study of systematic uncertainties linked to the foregrounds modelling in cosmological microwave background (CMB) data analysis, and on the impact of the present knowledge of the reionisation optical depth. This is done through the use of different likelihoods built from Planck data. Limits on Σmν are derived with various combinations of data, including the latest baryon acoustic oscillations (BAO) and Type Ia supernovae (SNIa) results. We also discuss the impact of the preference for current CMB data for amplitudes of the gravitational lensing distortions higher than expected within the ΛCDM model, and add the Planck CMB lensing. We then derive a robust upper limit: Σmνcosmological parameters is also reported, for different assumptions on the neutrino mass repartition, and different high and low multipole CMB likelihoods.

  19. CDNA encoding a polypeptide including a hevein sequence

    Science.gov (United States)

    Raikhel, Natasha V.; Broekaert, Willem F.; Chua, Nam-Hai; Kush, Anil

    1995-03-21

    A cDNA clone (HEV1) encoding hevein was isolated via polymerase chain reaction (PCR) using mixed oligonucleotides corresponding to two regions of hevein as primers and a Hevea brasiliensis latex cDNA library as a template. HEV1 is 1018 nucleotides long and includes an open reading frame of 204 amino acids. The deduced amino acid sequence contains a putative signal sequence of 17 amino acid residues followed by a 187 amino acid polypeptide. The amino-terminal region (43 amino acids) is identical to hevein and shows homology to several chitin-binding proteins and to the amino-termini of wound-induced genes in potato and poplar. The carboxyl-terminal portion of the polypeptide (144 amino acids) is 74-79% homologous to the carboxyl-terminal region of wound-inducible genes of potato. Wounding, as well as application of the plant hormones abscisic acid and ethylene, resulted in accumulation of hevein transcripts in leaves, stems and latex, but not in roots, as shown by using the cDNA as a probe. A fusion protein was produced in E. coli from the protein of the present invention and maltose binding protein produced by the E. coli.

  20. Apparatus including concave reflectors and a line of optical fibers

    International Nuclear Information System (INIS)

    Dolan, J.T.

    1992-01-01

    This patent describes an apparatus including a radiation source which emits in a multiplicity of directions for focusing radiation on an object which may receive radiation within a certain solid angle. It comprises a first reflector and a second reflector, the first reflector being elliptical in cross section and having a first focus and a second focus, the second reflector being circular in cross section and having a center, and a radius equal to the distance between the second reflector and the first focus, the first reflector and the second reflector being arranged so that a concave reflecting surface of the first reflector faces a concave reflecting surface of the second reflector, and so arranged that the first focus of the first reflector corresponds to the center of the second reflector, the radiation source being an elongated discharge bulb, the object being a group of two or more optical fibers defining at least one line of optical fibers which are located at the second focus of the first reflector

  1. 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.

  2. Pubertal induction in hypogonadism: Current approaches including use of gonadotrophins.

    Science.gov (United States)

    Zacharin, Margaret

    2015-06-01

    Primary disorders of the gonad or those secondary to abnormalities of the hypothalamic pituitary axis result in hypogonadism. The range of health problems of childhood and adolescence that affect this axis has increased, as most children now survive chronic illness, but many have persisting deficits in gonadal function as a result of their underlying condition or its treatment. An integrated approach to hormone replacement is needed to optimize adult hormonal and bone health, and to offer opportunities for fertility induction and preservation that were not considered possible in the past. Timing of presentation ranges from birth, with disorders of sexual development, through adolescent pubertal failure, to adult fertility problems. This review addresses diagnosis and management of hypogonadism and focuses on new management strategies to address current concerns with fertility preservation. These include Turner syndrome, and fertility presevation prior to childhood cancer treatment. New strategies for male hormone replacement therapy that may impinge upon future fertility are emphasized. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. A hydrodynamic model for granular material flows including segregation effects

    Science.gov (United States)

    Gilberg, Dominik; Klar, Axel; Steiner, Konrad

    2017-06-01

    The simulation of granular flows including segregation effects in large industrial processes using particle methods is accurate, but very time-consuming. To overcome the long computation times a macroscopic model is a natural choice. Therefore, we couple a mixture theory based segregation model to a hydrodynamic model of Navier-Stokes-type, describing the flow behavior of the granular material. The granular flow model is a hybrid model derived from kinetic theory and a soil mechanical approach to cover the regime of fast dilute flow, as well as slow dense flow, where the density of the granular material is close to the maximum packing density. Originally, the segregation model has been formulated by Thornton and Gray for idealized avalanches. It is modified and adapted to be in the preferred form for the coupling. In the final coupled model the segregation process depends on the local state of the granular system. On the other hand, the granular system changes as differently mixed regions of the granular material differ i.e. in the packing density. For the modeling process the focus lies on dry granular material flows of two particle types differing only in size but can be easily extended to arbitrary granular mixtures of different particle size and density. To solve the coupled system a finite volume approach is used. To test the model the rotational mixing of small and large particles in a tumbler is simulated.

  4. Radiation and nuclear safety included in the environmental health programme

    International Nuclear Information System (INIS)

    Salomaa, S.

    1996-01-01

    Finland is currently preparing a national environmental health programme, the objective of which is to chart the main environmental health problems in Finland, to identify means for securing a healthy environment, and to draw up a practical action programme for preventing and rectifying problems pertaining to environmental health. Radiation and nuclear safety form an essential part of preventive health care. The action programme is based on decisions and programmes approved at the WHO Conference on the Environment and Health, held in Helsinki in June 1994. In addition to the state of the Finnish environment and the health of the Finnish population, the programme addresses the relevant international issues, in particular in areas adjacent to Finland. The Committee on Environmental Health is expected to complete its work by the end of the year. A wide range of representatives from various branches of administration have contributed to the preparation of the programme. Besides physical, biological and chemical factors, the environmental factors affecting health also include the physical environment and the psychological, social and aesthetic features of the environment. Similarly, environmental factors that have an impact on the health of present or future generations, on the essential preconditions of life and on the quality of life are investigated. The serious risk to nature caused by human actions is also considered as a potential risk to human health. (orig.)

  5. A Reformed CDM - including new mechanisms for sustainable development

    Energy Technology Data Exchange (ETDEWEB)

    Holm Olsen, K.; Fenhann, J.

    2009-07-01

    The annual CD4CDM Perspectives Series features a topic of pivotal importance to the global carbon market. The series seeks to communicate the diverse insights and visions of leading actors in the carbon market to better inform the decisions of professionals and policymakers in developing countries. The second theme of the series focuses on how the CDM can be reformed in a post-2012 climate regime, including new mechanism for sustainable development. Seventeen contributors from the private sector, Designated National Authorities, the Executive Board, research, and development agencies present their perspective on meeting challenges such as the unequal regional distribution of CDM projects, concerns about environmental integrity and technology transfer, complex governance procedures, and questions about the CDM's contribution to sustainable development. The new ideas and solutions to these challenges proposed by the authors in this edition of Perspectives have been solicited to help professionals and policy makers make the best decisions in the lead-up to COP 15 in Copenhagen and beyond. (au)

  6. Kalaeloa Energy System Redevelopment Options Including Advanced Microgrids.

    Energy Technology Data Exchange (ETDEWEB)

    Hightower, Marion Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Baca, Michael J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); VanderMey, Carissa [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-03-01

    In June 2016, the Department of Energy's (DOE's) Office of Energy Efficiency and Renewable Energy (EERE) in collaboration with the Renewable Energy Branch for the Hawaii State Energy Office (HSEO), the Hawaii Community Development Authority (HCDA), the United States Navy (Navy), and Sandia National Laboratories (Sandia) established a project to 1) assess the current functionality of the energy infrastructure at the Kalaeloa Community Development District, and 2) evaluate options to use both existing and new distributed and renewable energy generation and storage resources within advanced microgrid frameworks to cost-effectively enhance energy security and reliability for critical stakeholder needs during both short-term and extended electric power outages. This report discusses the results of a stakeholder workshop and associated site visits conducted by Sandia in October 2016 to identify major Kalaeloa stakeholder and tenant energy issues, concerns, and priorities. The report also documents information on the performance and cost benefits of a range of possible energy system improvement options including traditional electric grid upgrade approaches, advanced microgrid upgrades, and combined grid/microgrid improvements. The costs and benefits of the different improvement options are presented, comparing options to see how well they address the energy system reliability, sustainability, and resiliency priorities identified by the Kalaeloa stakeholders.

  7. Advocacy for women's health should include lesbian health.

    Science.gov (United States)

    O'Hanlan, Katherine A; Dibble, Suzanne L; Hagan, H Jennifer J; Davids, Rachel

    2004-03-01

    Although research confirms that homosexuality is a normal expression of human sexuality, established scientific studies are often not reflected in laws and judicial opinions for lesbians with regard to employment, taxation, pensions, disability, healthcare, immigration, military service, marriage, custody, and adoption. The expression of homosexual attraction or behavior is sometimes met by disdain or violence. Psychological and epidemiological research confirms that the public discriminatory attitudes and second-class legal status cause physical, emotional, and financial harm to lesbians, their families, and their children. Some lesbians experience discrimination in healthcare and avoid routine primary healthcare. To decrease the harm, and improve the health of lesbians, medical institutions can include sexual orientation and gender identity in their nondiscrimination policies and offer domestic partner coverage in employment benefits. Our specialty societies should review current laws and judicial opinions and advocate for change. Further, specialty societies can effect change by issuing policy statements about issues of orientation and by writing orientation/identity curricula for public schools, colleges, and postcollegiate education to improve their accuracy, reduce sexually transmitted diseases, delay sexual activity, and reduce morbidity from homophobic violence.

  8. Project Interface Requirements Process Including Shuttle Lessons Learned

    Science.gov (United States)

    Bauch, Garland T.

    2010-01-01

    Most failures occur at interfaces between organizations and hardware. Processing interface requirements at the start of a project life cycle will reduce the likelihood of costly interface changes/failures later. This can be done by adding Interface Control Documents (ICDs) to the Project top level drawing tree, providing technical direction to the Projects for interface requirements, and by funding the interface requirements function directly from the Project Manager's office. The interface requirements function within the Project Systems Engineering and Integration (SE&I) Office would work in-line with the project element design engineers early in the life cycle to enhance communications and negotiate technical issues between the elements. This function would work as the technical arm of the Project Manager to help ensure that the Project cost, schedule, and risk objectives can be met during the Life Cycle. Some ICD Lessons Learned during the Space Shuttle Program (SSP) Life Cycle will include the use of hardware interface photos in the ICD, progressive life cycle design certification by analysis, test, & operations experience, assigning interface design engineers to Element Interface (EI) and Project technical panels, and linking interface design drawings with project build drawings

  9. Nuclear resonance apparatus including means for rotating a magnetic field

    International Nuclear Information System (INIS)

    Sugimoto, H.

    1983-01-01

    A nuclear magnetic resonance apparatus including magnet apparatus for generating a homogeneous static magnetic field between its magnetic poles, shims of a magnetic substance mounted on the magnetic poles to apply a first gradient magnetic field intensity distribution in a direction orthogonal as to the direction of line of magnetic force of the static magnetic field, gradient magnetic field generating electromagnetic apparatus for generating a second gradient magnetic field having a gradient magnetic field intensity distribution in superimposition with the static magnetic field and for changing the magnetic field gradient of the first gradient magnetic field, an oscillator for generating an oscillating output having a frequency corresponding to the nuclear magnetic resonance condition of an atomic nucleus to be measured, a coil wound around a body to be examined for applying the output of said oscillator as electromagnetic waves upon the body, a receiver for detecting the nuclear magnetic resonance signals received by the coil, a gradient magnetic field controller making a magnetic field line equivalent to the combined gradient magnetic fields and for rotating the line along the section of the body to be examined by controlling said gradient magnetic field generating electromagnetic apparatus and devices for recording the nuclear magnetic resonance signals, for reconstructing the concentration distribution of the specific atomic nuclei in the section of the body, and a display unit for depicting the result of reconstruction

  10. cDNA encoding a polypeptide including a hevein sequence

    Energy Technology Data Exchange (ETDEWEB)

    Raikhel, N.V.; Broekaert, W.F.; Chua, N.H.; Kush, A.

    2000-07-04

    A cDNA clone (HEV1) encoding hevein was isolated via polymerase chain reaction (PCR) using mixed oligonucleotides corresponding to two regions of hevein as primers and a Hevea brasiliensis latex cDNA library as a template. HEV1 is 1018 nucleotides long and includes an open reading frame of 204 amino acids. The deduced amino acid sequence contains a putative signal sequence of 17 amino acid residues followed by a 187 amino acid polypeptide. The amino-terminal region (43 amino acids) is identical to hevein and shows homology to several chitin-binding proteins and to the amino-termini of wound-induced genes in potato and poplar. The carboxyl-terminal portion of the polypeptide (144 amino acids) is 74--79% homologous to the carboxyl-terminal region of wound-inducible genes of potato. Wounding, as well as application of the plant hormones abscisic acid and ethylene, resulted in accumulation of hevein transcripts in leaves, stems and latex, but not in roots, as shown by using the cDNA as a probe. A fusion protein was produced in E. coli from the protein of the present invention and maltose binding protein produced by the E. coli.

  11. Student Motivation in Science Subjects in Tanzania, Including Students' Voices

    Science.gov (United States)

    Mkimbili, Selina Thomas; Ødegaard, Marianne

    2017-12-01

    Fostering and maintaining students' interest in science is an important aspect of improving science learning. The focus of this paper is to listen to and reflect on students' voices regarding the sources of motivation for science subjects among students in community secondary schools with contextual challenges in Tanzania. We conducted a group-interview study of 46 Form 3 and Form 4 Tanzanian secondary school students. The study findings reveal that the major contextual challenges to student motivation for science in the studied schools are limited resources and students' insufficient competence in the language of instruction. Our results also reveal ways to enhance student motivation for science in schools with contextual challenges; these techniques include the use of questioning techniques and discourse, students' investigations and practical work using locally available materials, study tours, more integration of classroom science into students' daily lives and the use of real-life examples in science teaching. Also we noted that students' contemporary life, culture and familiar language can be utilised as a useful resource in facilitating meaningful learning in science in the school. Students suggested that, to make science interesting to a majority of students in a Tanzanian context, science education needs to be inclusive of students' experiences, culture and contemporary daily lives. Also, science teaching and learning in the classroom need to involve learners' voices.

  12. Why include phenomenological analysis in a Research Methods course?

    Science.gov (United States)

    Delgado, Ana R

    2013-01-01

    Guidelines for Spanish university curricula include the descriptor Quantitative and Qualitative Methods, but the latter are still poorly represented. To inform the argument for phenomenological methods, the last 20-year interval of ISI databases has been content-analyzed with the following codes: discourse analysis, grounded theory, narrative analysis, phenomenological analysis and confirmatory factor analysis, that is, four qualitative methods and a prototypical quantitative one. In absolute terms, the most frequent qualitative method is grounded theory, followed by discourse analysis, phenomenological analysis and narrative analysis. However, taking into account content categories, only phenomenological analysis shows a clear psychological profile, similar to confirmatory factor analysis. We recommend starting qualitative training with a method that does not require either big groups, or big funding, and that has a procedural core that is simple, relatively well-delimited and "secularizable," a variety of thematic analysis. Historical reasons and the clear psychological profile evidenced by our results enhance our argument to foster the inclusion of phenomenological analysis in research method courses in psychology.

  13. Olkiluoto surface hydrological modelling: Update 2012 including salt transport modelling

    International Nuclear Information System (INIS)

    Karvonen, T.

    2013-11-01

    Posiva Oy is responsible for implementing a final disposal program for spent nuclear fuel of its owners Teollisuuden Voima Oyj and Fortum Power and Heat Oy. The spent nuclear fuel is planned to be disposed at a depth of about 400-450 meters in the crystalline bedrock at the Olkiluoto site. Leakages located at or close to spent fuel repository may give rise to the upconing of deep highly saline groundwater and this is a concern with regard to the performance of the tunnel backfill material after the closure of the tunnels. Therefore a salt transport sub-model was added to the Olkiluoto surface hydrological model (SHYD). The other improvements include update of the particle tracking algorithm and possibility to estimate the influence of open drillholes in a case where overpressure in inflatable packers decreases causing a hydraulic short-circuit between hydrogeological zones HZ19 and HZ20 along the drillhole. Four new hydrogeological zones HZ056, HZ146, BFZ100 and HZ039 were added to the model. In addition, zones HZ20A and HZ20B intersect with each other in the new structure model, which influences salinity upconing caused by leakages in shafts. The aim of the modelling of long-term influence of ONKALO, shafts and repository tunnels provide computational results that can be used to suggest limits for allowed leakages. The model input data included all the existing leakages into ONKALO (35-38 l/min) and shafts in the present day conditions. The influence of shafts was computed using eight different values for total shaft leakage: 5, 11, 20, 30, 40, 50, 60 and 70 l/min. The selection of the leakage criteria for shafts was influenced by the fact that upconing of saline water increases TDS-values close to the repository areas although HZ20B does not intersect any deposition tunnels. The total limit for all leakages was suggested to be 120 l/min. The limit for HZ20 zones was proposed to be 40 l/min: about 5 l/min the present day leakages to access tunnel, 25 l/min from

  14. Including spatial data in nutrient balance modelling on dairy farms

    Science.gov (United States)

    van Leeuwen, Maricke; van Middelaar, Corina; Stoof, Cathelijne; Oenema, Jouke; Stoorvogel, Jetse; de Boer, Imke

    2017-04-01

    The Annual Nutrient Cycle Assessment (ANCA) calculates the nitrogen (N) and phosphorus (P) balance at a dairy farm, while taking into account the subsequent nutrient cycles of the herd, manure, soil and crop components. Since January 2016, Dutch dairy farmers are required to use ANCA in order to increase understanding of nutrient flows and to minimize nutrient losses to the environment. A nutrient balance calculates the difference between nutrient inputs and outputs. Nutrients enter the farm via purchased feed, fertilizers, deposition and fixation by legumes (nitrogen), and leave the farm via milk, livestock, manure, and roughages. A positive balance indicates to which extent N and/or P are lost to the environment via gaseous emissions (N), leaching, run-off and accumulation in soil. A negative balance indicates that N and/or P are depleted from soil. ANCA was designed to calculate average nutrient flows on farm level (for the herd, manure, soil and crop components). ANCA was not designed to perform calculations of nutrient flows at the field level, as it uses averaged nutrient inputs and outputs across all fields, and it does not include field specific soil characteristics. Land management decisions, however, such as the level of N and P application, are typically taken at the field level given the specific crop and soil characteristics. Therefore the information that ANCA provides is likely not sufficient to support farmers' decisions on land management to minimize nutrient losses to the environment. This is particularly a problem when land management and soils vary between fields. For an accurate estimate of nutrient flows in a given farming system that can be used to optimize land management, the spatial scale of nutrient inputs and outputs (and thus the effect of land management and soil variation) could be essential. Our aim was to determine the effect of the spatial scale of nutrient inputs and outputs on modelled nutrient flows and nutrient use efficiencies

  15. Four new massive pulsating white dwarfs including an ultramassive DAV

    Science.gov (United States)

    Curd, Brandon; Gianninas, A.; Bell, Keaton J.; Kilic, Mukremin; Romero, A. D.; Allende Prieto, Carlos; Winget, D. E.; Winget, K. I.

    2017-06-01

    We report the discovery of four massive (M > 0.8 M⊙) ZZ Ceti white dwarfs, including an ultramassive 1.16 M⊙ star. We obtained ground-based, time series photometry for 13 white dwarfs from the Sloan Digital Sky Survey Data Release 7 and Data Release 10 whose atmospheric parameters place them within the ZZ Ceti instability strip. We detect monoperiodic pulsations in three of our targets (J1015, J1554 and J2038) and identify three periods of pulsation in J0840 (173, 327 and 797 s). Fourier analysis of the remaining nine objects does not indicate variability above the 4 detection threshold. Our preliminary asteroseismic analysis of J0840 yields a stellar mass M = 1.14 ± 0.01 M⊙, hydrogen and helium envelope masses of MH = 5.8 × 10-7 M⊙ and MHe = 4.5 × 10-4 M⊙ and an expected core crystallized mass ratio of 50-70 per cent. J1015, J1554 and J2038 have masses in the range 0.84-0.91 M⊙ and are expected to have a CO core; however, the core of J0840 could consist of highly crystallized CO or ONeMg given its high mass. These newly discovered massive pulsators represent a significant increase in the number of known ZZ Ceti white dwarfs with mass M > 0.85 M⊙, and detailed asteroseismic modelling of J0840 will allow for significant tests of crystallization theory in CO and ONeMg core white dwarfs.

  16. A study of helicopter stability and control including blade dynamics

    Science.gov (United States)

    Zhao, Xin; Curtiss, H. C., Jr.

    1988-01-01

    A linearized model of rotorcraft dynamics has been developed through the use of symbolic automatic equation generating techniques. The dynamic model has been formulated in a unique way such that it can be used to analyze a variety of rotor/body coupling problems including a rotor mounted on a flexible shaft with a number of modes as well as free-flight stability and control characteristics. Direct comparison of the time response to longitudinal, lateral and directional control inputs at various trim conditions shows that the linear model yields good to very good correlation with flight test. In particular it is shown that a dynamic inflow model is essential to obtain good time response correlation, especially for the hover trim condition. It also is shown that the main rotor wake interaction with the tail rotor and fixed tail surfaces is a significant contributor to the response at translational flight trim conditions. A relatively simple model for the downwash and sidewash at the tail surfaces based on flat vortex wake theory is shown to produce good agreement. Then, the influence of rotor flap and lag dynamics on automatic control systems feedback gain limitations is investigated with the model. It is shown that the blade dynamics, especially lagging dynamics, can severly limit the useable values of the feedback gain for simple feedback control and that multivariable optimal control theory is a powerful tool to design high gain augmentation control system. The frequency-shaped optimal control design can offer much better flight dynamic characteristics and a stable margin for the feedback system without need to model the lagging dynamics.

  17. Parameningeal rhabdomyosarcoma (including the orbit): results of orbital irradiation

    International Nuclear Information System (INIS)

    Jereb, B.; Haik, B.G.; Ong, R.; Ghavimi, F.

    1985-01-01

    Twenty-three patients with parameningeal (including orbital rhabdomyosarcoma (RMS)) were treated at Memorial Sloan-Kettering Cancer Center (MSKCC) between July 1971 and January 1983. Twenty were children with a mean age of 6 and 3 were adults. In 6 patients, the primary tumor was from the orbit, whereas the remaining 17 had other parameningeal primary sites. The tumors were in a very progressive local stage, with extensive destruction of the facial bones in 19 patients. Eight patients were treated with T2 chemotherapy protocol and 15 received T6. Seven patients received 5,000 to 7,200 rad delivered to the primary tumor in 11-16 weeks, 15 patients received between 4,500 to 5,000 rad in 4-7 weeks, and 1 patient received 3,000 rad in 3 weeks for residual microscopic disease following surgery. Two patients were treated with radiation to the whole brain; no patients received radiation of the whole central nervous axis (CNA). Fifteen of the 23 patients (65%) are alive and well with a medical follow-up time of 5 years. Two patients died of therapeutic complications and six died of tumor spread. In five patients, involvement of the central nervous system (CNS) was the cause of death. The prognosis of orbital RMS with parameningeal involvement is no better than in other tumors of parameningeal sites. In those patients who had impaired vision because of optic nerve damage prior to treatment, the vision did not improve following treatment. There was no impaired vision seen due to radiation damage of eye structures except in the lens

  18. Refining borders of genome-rearrangements including repetitions.

    Science.gov (United States)

    Arjona-Medina, J A; Trelles, O

    2016-10-25

    DNA rearrangement events have been widely studied in comparative genomic for many years. The importance of these events resides not only in the study about relatedness among different species, but also to determine the mechanisms behind evolution. Although there are many methods to identify genome-rearrangements (GR), the refinement of their borders has become a huge challenge. Until now no accepted method exists to achieve accurate fine-tuning: i.e. the notion of breakpoint (BP) is still an open issue, and despite repeated regions are vital to understand evolution they are not taken into account in most of the GR detection and refinement methods. We propose a method to refine the borders of GR including repeated regions. Instead of removing these repetitions to facilitate computation, we take advantage of them using a consensus alignment sequence of the repeated region in between two blocks. Using the concept of identity vectors for Synteny Blocks (SB) and repetitions, a Finite State Machine is designed to detect transition points in the difference between such vectors. The method does not force the BP to be a region or a point but depends on the alignment transitions within the SBs and repetitions. The accurate definition of the borders of SB and repeated genomic regions and consequently the detection of BP might help to understand the evolutionary model of species. In this manuscript we present a new proposal for such a refinement. Features of the SBs borders and BPs are different and fit with what is expected. SBs with more diversity in annotations and BPs short and richer in DNA replication and stress response, which are strongly linked with rearrangements.

  19. Refining borders of genome-rearrangements including repetitions

    Directory of Open Access Journals (Sweden)

    JA Arjona-Medina

    2016-10-01

    Full Text Available Abstract Background DNA rearrangement events have been widely studied in comparative genomic for many years. The importance of these events resides not only in the study about relatedness among different species, but also to determine the mechanisms behind evolution. Although there are many methods to identify genome-rearrangements (GR, the refinement of their borders has become a huge challenge. Until now no accepted method exists to achieve accurate fine-tuning: i.e. the notion of breakpoint (BP is still an open issue, and despite repeated regions are vital to understand evolution they are not taken into account in most of the GR detection and refinement methods. Methods and results We propose a method to refine the borders of GR including repeated regions. Instead of removing these repetitions to facilitate computation, we take advantage of them using a consensus alignment sequence of the repeated region in between two blocks. Using the concept of identity vectors for Synteny Blocks (SB and repetitions, a Finite State Machine is designed to detect transition points in the difference between such vectors. The method does not force the BP to be a region or a point but depends on the alignment transitions within the SBs and repetitions. Conclusion The accurate definition of the borders of SB and repeated genomic regions and consequently the detection of BP might help to understand the evolutionary model of species. In this manuscript we present a new proposal for such a refinement. Features of the SBs borders and BPs are different and fit with what is expected. SBs with more diversity in annotations and BPs short and richer in DNA replication and stress response, which are strongly linked with rearrangements.

  20. Monitoring of tritium-contaminated surfaces, including skin

    International Nuclear Information System (INIS)

    Surette, R.A.; Wood, M.J.

    1994-05-01

    We have examined various commercially available tritium surface contamination monitors along with different swipe media and techniques for direct and indirect (swipe) monitoring of contaminated surfaces, including skin. None of the methods or instruments evaluated were more sensitive than the swipe and liquid scintillation counting (LSC) method. Swipe measurements with open-window proportional counters were, in general, less than half as sensitive as LSC, but have the advantages of having the results available almost immediately, and no sample preparation is required. The Nuclear Measurement Corporation's PC-55 is the most suitable instrument we tested for the analysis of routine swipe measurement. The PC-55 was about one third as sensitive as LSC when used with Ontario Hydro filter paper swipe media. Surface contamination measurement results can be obtained within minutes using the PC-55, compared to hours using LSC. The selection of swipe media for use with proportional counter-based instruments is critical. A medium that is electrically insulating can develop an electrostatic charge on its surface; this may alter the field gradient in the detector and may adversely influence the results. Although the PC-55 is sufficiently sensitive and very convenient, operational experience with the instrument is needed before recommending that it replace current LSC methods. The PC-55's susceptibility to internal tritium contamination may limit its practical usefulness. Because of the complexity of using live animals to evaluate direct and indirect methods for assessing skin contamination, pig skin was investigated as a possible substitute. We concluded that, for the first few hours post-exposure, pig skin mimics the kinetics of animal skin that has contacted a tritium-contaminated surface. (author). 30 refs., 1 tab., 7 figs

  1. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  2. How Might Industry Governance Be Broadened To Include Nonproliferation

    International Nuclear Information System (INIS)

    Hund, Gretchen; Seward, Amy M.

    2009-01-01

    Broadening industry governance to support nonproliferation could provide significant new leverage in preventing the spread/diversion of nuclear, radiological, or dual-use material or technology that could be used in making a nuclear or radiological weapon. Industry is defined broadly to include (1) the nuclear industry, (2) dual-use industries, and (3) radioactive source manufacturers and selected radioactive source-user industries worldwide. This paper describes how industry can be an important first line of defense in detecting and thwarting proliferation, such as an illicit trade network or an insider theft case, by complementing and strengthening existing governmental efforts. For example, the dual-use industry can play a critical role by providing export, import, or security control information that would allow a government or the International Atomic Energy Agency (IAEA) to integrate this information with safeguards, export, import, and physical protection information it has to create a more complete picture of the potential for proliferation. Because industry is closest to users of the goods and technology that could be illicitly diverted throughout the supply chain, industry information can potentially be more timely and accurate than other sources of information. Industry is in an ideal position to help ensure that such illicit activities are detected. This role could be performed more effectively if companies worked together within a particular industry to promote nonproliferation by implementing an industry-wide self-regulation program. Performance measures could be used to ensure their materials and technologies are secure throughout the supply chain and that customers are legitimately using and/or maintaining oversight of these items. Nonproliferation is the overarching driver that industry needs to consider in adopting and implementing a self-regulation approach. A few foreign companies have begun such an approach to date; it is believed that

  3. Studying Irony Detection Beyond Ironic Criticism: Let's Include Ironic Praise

    Directory of Open Access Journals (Sweden)

    Richard Bruntsch

    2017-04-01

    criticism. Generating unique variance in irony detection, ironic praise can be postulated as worthwhile to include in future studies—especially when studying the role of mental ability, personality, and humor in irony detection.

  4. Including collisions in gyrokinetic tokamak and stellarator simulations

    Energy Technology Data Exchange (ETDEWEB)

    Kauffmann, Karla

    2012-04-10

    ITGs and TEMs in a tokamak configuration. The results show that collisions reduce the growth rate of slab ITGs in cylinder geometry, whereas they do not affect ITGs in a tokamak, which are mainly curvature-driven. However it is important to note that the pitch-angle scattering operator does not conserve momentum, which is most critical in the parallel direction. Therefore, the damping found in a cylinder could be the consequence of this missing feature and not a physical result [Dimits and Cohen 1994]. Nonetheless, the results are useful to determine whether the instability is mainly being driven by a slab or toroidal ITG mode. EUTERPE also has the feature of including kinetic electrons, which made simulations of TEMs with collisions possible. The combination of collisions and kinetic electrons made the numerical calculations extremely time-consuming, since the time step had to be small enough to resolve the fast electron motion. In contrast to the ITG results, it was observed that collisions are extremely important for TEMs in a tokamak, and in some special cases, depending on whether they were mainly driven by density or temperature gradients, collisions could even suppress the mode (in agreement with [Angioni et al. 2005, Connor et al. 2006]). In the case of stellarators it was found that ITGs are highly dependent on the device configuration. For LHD it was shown that collisions slightly reduce the growth rate of the instability, but for Wendelstein 7-X they do not affect it and the growth rate showed a similar trend with collisionality to that of the tokamak case. Collisions also tend to make the ballooning structure of the modes less pronounced.

  5. Capturing Uncertainty in Fatigue Life Data

    Science.gov (United States)

    2014-09-18

    to gauge the effectiveness of the transformation. Specific tests have been developed for log-transformed data (Bartlett & Kendall , 1946). This work...techniques have parametric counterparts including two-sample location tests Wilcoxen Rank Sum/ Mann -Whitney U (t- test for difference of means), Kruskal...of time they have spent with me discussing material sciences, fatigue testing , and their modeling efforts. Finally, a considerable amount of thanks

  6. Evaluation of thromboelastography in bitches with pyometra.

    Science.gov (United States)

    Dorsey, Tovah I; Rozanski, Elizabeth A; Sharp, Claire R; Babyak, Jonathan M; de Laforcade, Armelle M

    2018-01-01

    We investigated the effect of pyometra on kaolin-activated thromboelastography (TEG). Eighteen client-owned dogs with pyometra and 8 healthy spayed dogs were recruited. TEG parameters and packed cell volume were determined. Results from spayed females and from intact females with pyometra were compared using a Student t-test and Wilcoxon rank sum test. Bitches with pyometra were hypercoagulable compared to spayed bitches as evidenced by elevated maximum amplitude, G, and alpha angle. There were no significant group differences in R time, K time, or clot lysis at 30 or 60 min. Dogs with pyometra should be anticipated to have hypercoagulable TEG variables, and this should be addressed when planning surgical and medical therapy.

  7. Make a Move Intervention to Reduce Childhood Obesity.

    Science.gov (United States)

    Nerud, Kimberly; Samra, Haifa Abou

    2017-06-01

    Guided by the social cognitive theory, this randomized controlled trial tested the "Make a Move," a provider-led intervention for Head Start parents aimed to produce changes in the outcomes of knowledge, attitude, and behavior of physical activity and healthy eating. Participants were parents of children ages 3-5 years enrolled in a Head Start program. Participants completed a 57-item questionnaire at baseline and postintervention. The Wilcoxon rank-sum test revealed a statistically significant difference between the intervention and control groups in scores on knowledge of healthy eating ( z = 1.99, p = .05), attitude of physical activity ( z = 2.71, p intervention sessions. This study provided new insights into the relationship of a provider-led intervention with respect to knowledge, attitude, and behaviors in healthy eating and physical activity.

  8. Antenatal small-class education versus auditorium-based lectures to promote positive transitioning to parenthood

    DEFF Research Database (Denmark)

    Koushede, Vibeke; Brixval, Carina Sjöberg; Thygesen, Lau Caspar

    2017-01-01

    trial, we examined the effect of antenatal education in small classes versus auditorium-based lectures on perceived stress, parenting stress, and parenting alliance. A total of 1,766 pregnant women were randomised to receive: antenatal education in small classes three times in pregnancy and one time......Prospective parents widely use education to gain information about, e.g., labour and parenting skills. It is unknown if antenatal education in small classes is more beneficial for parenting stress and parenting alliance compared with other types of antenatal education. In the present randomised...... alliance six months postpartum was examined using the non-parametric Wilcoxon rank-sum test. Antenatal education in small classes had a small beneficial main effect on global feelings of stress six months postpartum and a statistically significant interaction between time and group favoring antenatal...

  9. General Surgery Resident Satisfaction on Cardiothoracic Rotations.

    Science.gov (United States)

    Lussiez, Alisha; Bevins, Jack; Plaska, Andrew; Rosin, Vadim; Reddy, Rishindra M

    2016-01-01

    General surgery residents' exposure to cardiothoracic (CT) surgery rotations has decreased, which may affect resident satisfaction. We surveyed general surgery graduates to assess the relationships among rotation satisfaction, CT disease exposure, rotation length, mentorship, and mistreatment. A survey assessing CT curriculum, exposure, mentorship, and satisfaction was forwarded to general surgery graduates from 17 residency programs. A Wilcoxon rank-sum test was used to assess statistical significance of ordinal level data. Statistical significance was defined as p surgery residency programs who graduated between the years of 1999 to 2014. A total of 94 responses were completed and received. Receiving adequate exposure to CT procedures and disease management was significantly associated with higher satisfaction ratings for all procedures, particularly thoracotomy incisions (p Surgery. Published by Elsevier Inc. All rights reserved.

  10. Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study.

    Science.gov (United States)

    Parker, L A; Sullivan, S; Krueger, C; Kelechi, T; Mueller, M

    2012-03-01

    The purpose of this randomized pilot study was to collect preliminary data regarding the feasibility and effects of early initiation of milk expression on the onset of lactogenesis stage II and milk volume in mothers of very low birth weight (VLBW) infants. Twenty women were randomized to initiate milk expression within 60 min (group 1) or 1 to 6 h (group 2) following delivery. Milk volume and timing of lactogenesis stage II was compared between groups using Wilcoxon's rank sum tests. Group 1 produced statistically significantly more milk than group 2 during the first 7 days (P=0.05) and at week 3 (P=0.01). Group 1 also demonstrated a significantly earlier lactogenesis stage II (P=0.03). Initiation of milk expression within 1 h following delivery increases milk volume and decreases time to lactogenesis stage II in mothers of VLBW infants.

  11. Optimization of a statistical algorithm for objective comparison of toolmarks.

    Science.gov (United States)

    Spotts, Ryan; Chumbley, L Scott; Ekstrand, Laura; Zhang, Song; Kreiser, James

    2015-03-01

    Due to historical legal challenges, there is a driving force for the development of objective methods of forensic toolmark identification. This study utilizes an algorithm to separate matching and nonmatching shear cut toolmarks created using fifty sequentially manufactured pliers. Unlike previously analyzed striated screwdriver marks, shear cut marks contain discontinuous groups of striations, posing a more difficult test of algorithm applicability. The algorithm compares correlation between optical 3D toolmark topography data, producing a Wilcoxon rank sum test statistic. Relative magnitude of this metric separates the matching and nonmatching toolmarks. Results show a high degree of statistical separation between matching and nonmatching distributions. Further separation is achieved with optimized input parameters and implementation of a "leash" preventing a previous source of outliers--however complete statistical separation was not achieved. This paper represents further development of objective methods of toolmark identification and further validation of the assumption that toolmarks are identifiably unique. © 2014 American Academy of Forensic Sciences.

  12. Tissue Microarray Analysis of Hormonal Signaling Pathways in Uterine Carcinosarcoma

    Science.gov (United States)

    HUANG, Gloria S.; AREND, Rebecca C.; LI, Maomi; GUNTER, Marc J.; CHIU, Lydia G.; HORWITZ, Susan BAND; GOLDBERG, Gary L.

    2009-01-01

    Objectives To evaluate the relationship of hormone (ERα, ERβ, PR) and growth factor receptor (IGF1R, HER2) expression with disease progression in uterine carcinosarcoma. Study Design Immunohistochemistry was performed on tissue arrays using standard methodology. Differences between groups were evaluated by the Wilcoxon rank-sum test. Interactions between tumor stage and receptor expression were determined by linear trend analysis. Results Compared to normal endometrium, carcinosarcomas exhibited low ERα and PR expression (all Pcarcinosarcoma compared with normal endometrium (P=0.01). HER2 expression was elevated and increased with disease progression (Pcarcinosarcoma, ERβ expression is elevated and increases with disease progression, whereas ERα and PR are suppressed. HER2 expression is increased while IGF1R is lower than in normal endometrium. These data support a potential role for ERβ in disease progression via crosstalk with HER2. PMID:19200930

  13. Co-expression of GPR30 and ERβ and their association with disease progression in uterine carcinosarcoma

    Science.gov (United States)

    Huang, Gloria S.; Gunter, Marc J.; Arend, Rebecca C.; Li, Maomi; Arias-Pulido, Hugo; Prossnitz, Eric R.; Goldberg, Gary L.; Smith, Harriet O.

    2010-01-01

    Objective To evaluate the expression of G-coupled protein receptor 30 (GPR30) and estrogen receptor beta (ERβ) in uterine carcinosarcoma. Study Design Immunohistochemistry was performed using antibodies to GPR30, ERβ, estrogen receptor alpha (ERα), and progesterone receptor (PR). The staining intensity and percentage of positive cells were scored for each tissue section. Expression levels were compared using the Wilcoxon rank-sum test. Correlation was evaluated by Spearman’s rho and logistic regression. Results Compared with normal endometrium, carcinosarcoma had lower ERα and PR expression (both pcarcinosarcoma had higher GPR30 (pcarcinosarcoma. Expression of GPR30 and ERβ correlated with each other (pcarcinosarcoma, GPR30 and ERβ are coordinately overexpressed and expression levels increase in advanced stage disease, supporting the involvement of alternative estrogen receptors in disease progression. PMID:20605134

  14. Hospitalizations and skilled nursing facility admissions before and after the implementation of a home-based primary care program.

    Science.gov (United States)

    Wajnberg, Ania; Wang, Karen H; Aniff, Mohamed; Kunins, Hillary V

    2010-06-01

    To evaluate the effect of an urban house calls program (HCP) on healthcare utilization. Retrospective chart review with pre/post analysis. Urban home-based primary care program. All participants (N=179) in a capitated insurance program enrolled in a HCP between October 2004 and August 2006. Enrollment into HCP. Hospitalizations and skilled nursing facility (SNF) admissions before and after enrollment. Patients with at least one hospitalization or SNF admission before and after enrollment were compared using the McNemar test. Median number of hospitalizations and SNF placements before and after HCP enrollment were compared using the Wilcoxon signed-rank sum test. Sixty-one percent of patients had one or more hospitalizations before enrollment, whereas only 38% had one or more hospitalizations after enrollment (Plife are critical to help homebound older adults remain in their communities.

  15. Transcriptional analysis of left-sided colitis, pancolitis, and ulcerative colitis-associated dysplasia

    DEFF Research Database (Denmark)

    Bjerrum, Jacob T; Nielsen, Ole H; Riis, Lene B

    2014-01-01

    to identify potential biomarkers and transcripts of importance for the carcinogenic behavior of chronic inflammation. METHODS: The Affymetrix GeneChip Human Genome U133 Plus 2.0 was applied on colonic biopsies from UC patients with left-sided UC, pancolitis, dysplasia, and controls. Reverse transcription...... polymerase chain reaction and immunohistochemistry were performed for validating selected transcripts in the initial cohort and in 2 independent cohorts of patients with UC. Microarray data were analyzed by principal component analysis, and reverse transcription polymerase chain reaction...... and immunohistochemistry data by the Wilcoxon's rank-sum test. RESULTS: The principal component analysis results revealed separate clusters for left-sided UC, pancolitis, dysplasia, and controls. Close clustering of dysplastic and pancolitic samples indicated similarities in gene expression. Indeed, 101 and 656 parallel...

  16. A comparison of human dental pulp response to calcium hydroxide and Biodentine as direct pulp-capping agents.

    Science.gov (United States)

    Jalan, Anushka Lalit; Warhadpande, Manjusha M; Dakshindas, Darshan M

    2017-01-01

    Direct pulp capping involves the placement of a biocompatible agent on pulp tissue that has been inadvertently exposed from traumatic injury or by iatrogenic means. To compare the human pulp response to calcium hydroxide and Biodentine as direct pulp-capping agents. Pulp exposures were performed on the pulpal floor of forty human permanent premolars. The exposure sites were dressed with either Dycal or Biodentine as pulp-capping materials. After 45 days, teeth were extracted and processed for histological examination. The histological data were subjected to Wilcoxon rank-sum test. The dentinal bridges in teeth that were capped with Biodentine were significantly thicker ( P Biodentine can be suggested as the material of choice for direct pulp capping procedure instead of Dycal. However, further long-term follow-up in vivo human studies using Biodentine on cariously exposed pulpal teeth are warranted to derive a definite conclusion.

  17. Did AIDS mortality decrease the number of lifetime sexual partners in Kenya: an ecological analysis?

    Science.gov (United States)

    Kenyon, C R; Schwartz, I; Buyze, J

    2016-02-01

    We assessed if there has been a decline in the median number of reported lifetime sexual partners in Kenya following the AIDS epidemic. The Wilcoxon rank-sum test was used to compare the median and interquartile range (IQR) of the number of lifetime sexual partners for men aged 20-54 years in the 1993 and 2008 Kenyan Demographic Health Surveys. The median number of sexual partners in 1993 increased rapidly to 10 partners reported at age 30 years then plateaued at this level. In 2008, the median number of sexual partners plateaued at around half the value of the 1993 plateau. The median number of lifetime sexual partners for men aged 20-54 years declined from 10 (IQR 4-20) in 1993 to 3 (IQR 2-7) in 2008 (P bias.

  18. Complement activation capacity in plasma before and during high-dose prednisolone treatment and tapering in exacerbations of Crohn's disease and ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Baatrup Gunnar

    2005-09-01

    Full Text Available Abstract Background Ulcerative colitis (UC and Crohn's disease (CD are characterized by intestinal inflammation mainly caused by a disturbance in the balance between cytokines and increased complement (C activation. Our aim was to evaluate possible associations between C activation capacity and prednisolone treatment. Methods Plasma from patients with exacerbations of UC (n = 18 or CD (n = 18 were collected before and during high dose prednisolone treatment (1 mg/kg body weight and tapering. Friedman's two way analysis of variance, Mann-Whitney U test and Wilcoxon signed-rank sum test were used Results Before treatment, plasma from CD patients showed significant elevations in all C-mediated analyses compared to the values obtained from 38 healthy controls (p Conclusion Our findings indicate that C activation capacity is up-regulated significantly in plasma from CD patients. The decreases observed after prednisolone treatment reflect a general down-regulation in immune activation.

  19. Complement activation capacity in plasma before and during high-dose prednisolone treatment and tapering in exacerbations of Crohn's disease and ulcerative colitis

    DEFF Research Database (Denmark)

    Zimmermann-Nielsen, Erik; Grønbaek, Henning; Dahlerup, Jens Frederik

    2005-01-01

    BACKGROUND: Ulcerative colitis (UC) and Crohn's disease (CD) are characterized by intestinal inflammation mainly caused by a disturbance in the balance between cytokines and increased complement (C) activation. Our aim was to evaluate possible associations between C activation capacity...... and prednisolone treatment. METHODS: Plasma from patients with exacerbations of UC (n = 18) or CD (n = 18) were collected before and during high dose prednisolone treatment (1 mg/kg body weight) and tapering. Friedman's two way analysis of variance, Mann-Whitney U test and Wilcoxon signed-rank sum test were used...... RESULTS: Before treatment, plasma from CD patients showed significant elevations in all C-mediated analyses compared to the values obtained from 38 healthy controls (p UC patients (p

  20. Screening for major depressive disorder in adults with glioma using the PHQ-9: a comparison of patient versus proxy reports.

    Science.gov (United States)

    Rooney, Alasdair Grant; McNamara, Shanne; Mackinnon, Mairi; Fraser, Mary; Rampling, Roy; Carson, Alan; Grant, Robin

    2013-05-01

    When screening for depression in glioma patients, the utility of proxy carer report is unknown. We studied how patients and proxies differed in the frequency, severity and agreement of reported depressive symptoms, the external validity of these reports, and whether patient-proxy agreement was associated with cognitive function. This was a cross-sectional study within a prospective cohort study of depression in glioma. Eligible patients were adults with a new diagnosis of cerebral glioma whose cohabiting partners chose to attend study interviews. Patients completed the Patient Health Questionnaire-9 (PHQ-9, maximum score 27) to screen for major depressive disorder. Proxies independently completed the PHQ-9 'for the patient'. A structured clinical interview for MDD was then given. From 55 couples attending, 41 participated (74 %). Patient-proxy total PHQ-9 score differed by 3 or more points in 26/41 cases (63.4 %). Disagreement within dyads ranged from -7 to +10 points. Proxies observed more individual depressive symptoms than patients reported (mean 2.7 vs 1.8 symptoms respectively, p = 0.013, Wilcoxon Rank Sum Test), and a greater severity of symptom burden (mean PHQ-9 score 8.4 vs 6.8 respectively, p = 0.016, Wilcoxon Rank Sum Test). Proxies were more reliable than patients on objective behavioural symptoms of depression. Dyadic agreement was not associated with severity of patient cognitive impairment. There was frequent disagreement between glioma patients and proxies reports of depressive symptoms. Proxies reported more depressive symptoms than patients, and were more reliable when reporting observable behavioural symptoms. When diagnosing depression in glioma, collateral history should be obtained.

  1. Correlation between tumour characteristics, SUV measurements, metabolic tumour volume, TLG and textural features assessed with {sup 18}F-FDG PET in a large cohort of oestrogen receptor-positive breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Lemarignier, Charles; Groheux, David [Saint-Louis Hospital, Assistance Publique - Hopitaux de Paris, Department of Nuclear Medicine, Paris (France); University Sorbonne Paris Cite, INSERM/CNRS UMR944/7212, Paris (France); Martineau, Antoine; Vercellino, Laetitia; Merlet, Pascal [Saint-Louis Hospital, Assistance Publique - Hopitaux de Paris, Department of Nuclear Medicine, Paris (France); Teixeira, Luis; Espie, Marc [Saint-Louis Hospital, Breast Diseases Unit, Paris (France); University Sorbonne Paris Cite, INSERM/CNRS UMR944/7212, Paris (France)

    2017-07-15

    The study was designed to evaluate 1) the relationship between PET image textural features (TFs) and SUVs, metabolic tumour volume (MTV), total lesion glycolysis (TLG) and tumour characteristics in a large prospective and homogenous cohort of oestrogen receptor-positive (ER+) breast cancer (BC) patients, and 2) the capability of those parameters to predict response to neoadjuvant chemotherapy (NAC). 171 consecutive patients with large or locally advanced ER+ BC without distant metastases underwent an {sup 18}F-FDG PET examination before NAC. The primary tumour was delineated with an adaptive threshold segmentation method. Parameters of volume, intensity and texture (entropy, homogeneity, contrast and energy) were measured and compared with tumour characteristics determined on pre-treatment breast biopsy (Wilcoxon rank-sum test). The correlation between PET-derived parameters was determined using Spearman's coefficient. The relationship between PET features and pathological findings was determined using the Wilcoxon rank-sum test. Spearman's coefficients between SUV{sub max} and TFs were 0.43, 0.24, -0.43 and -0.15 respectively for entropy, homogeneity, energy and contrast; they were higher between MTV and TFs: 0.99, 0.86, -0.99 and -0.87. All TFs showed a significant association with the histological type (IDC vs. ILC; 0.02 < P < 0.03) but didn't with immunohistochemical characteristics. SUV{sub max} and TLG predicted the pathological response (P = 0.0021 and P = 0.02 respectively); TFs didn't (P: 0.27, 0.19, 0.94, 0.19 respectively for entropy, homogeneity, energy and contrast). The correlation of TFs was poor with SUV parameters and high with MTV. TFs showed a significant association with the histological type. Finally, while SUV{sub max} and TLG were able to predict response to NAC, TFs failed. (orig.)

  2. ICE MINERALOGY ACROSS AND INTO THE SURFACES OF PLUTO, TRITON, AND ERIS

    International Nuclear Information System (INIS)

    Tegler, S. C.; Grundy, W. M.; Olkin, C. B.; Young, L. A.; Romanishin, W.; Cornelison, D. M.; Khodadadkouchaki, R.

    2012-01-01

    We present three near-infrared spectra of Pluto taken with the Infrared Telescope Facility and SpeX, an optical spectrum of Triton taken with the MMT and the Red Channel Spectrograph, and previously published spectra of Pluto, Triton, and Eris. We combine these observations with a two-phase Hapke model and gain insight into the ice mineralogy on Pluto, Triton, and Eris. Specifically, we measure the methane-nitrogen mixing ratio across and into the surfaces of these icy dwarf planets. In addition, we present a laboratory experiment that demonstrates it is essential to model methane bands in spectra of icy dwarf planets with two methane phases—one highly diluted by nitrogen and the other rich in methane. For Pluto, we find bulk, hemisphere-averaged, methane abundances of 9.1% ± 0.5%, 7.1% ± 0.4%, and 8.2% ± 0.3% for sub-Earth longitudes of 10°, 125°, and 257°. Application of the Wilcoxon rank sum test to our measurements finds these small differences are statistically significant. For Triton, we find bulk, hemisphere-averaged, methane abundances of 5.0% ± 0.1% and 5.3% ± 0.4% for sub-Earth longitudes of 138° and 314°. Application of the Wilcoxon rank sum test to our measurements finds the differences are not statistically significant. For Eris, we find a bulk, hemisphere-averaged, methane abundance of 10% ± 2%. Pluto, Triton, and Eris do not exhibit a trend in methane-nitrogen mixing ratio with depth into their surfaces over the few centimeter range probed by these observations. This result is contrary to the expectation that since visible light penetrates deeper into a nitrogen-rich surface than the depths from which thermal emission emerges, net radiative heating at depth would drive preferential sublimation of nitrogen leading to an increase in the methane abundance with depth.

  3. Analysis of small sample size studies using nonparametric bootstrap test with pooled resampling method.

    Science.gov (United States)

    Dwivedi, Alok Kumar; Mallawaarachchi, Indika; Alvarado, Luis A

    2017-06-30

    Experimental studies in biomedical research frequently pose analytical problems related to small sample size. In such studies, there are conflicting findings regarding the choice of parametric and nonparametric analysis, especially with non-normal data. In such instances, some methodologists questioned the validity of parametric tests and suggested nonparametric tests. In contrast, other methodologists found nonparametric tests to be too conservative and less powerful and thus preferred using parametric tests. Some researchers have recommended using a bootstrap test; however, this method also has small sample size limitation. We used a pooled method in nonparametric bootstrap test that may overcome the problem related with small samples in hypothesis testing. The present study compared nonparametric bootstrap test with pooled resampling method corresponding to parametric, nonparametric, and permutation tests through extensive simulations under various conditions and using real data examples. The nonparametric pooled bootstrap t-test provided equal or greater power for comparing two means as compared with unpaired t-test, Welch t-test, Wilcoxon rank sum test, and permutation test while maintaining type I error probability for any conditions except for Cauchy and extreme variable lognormal distributions. In such cases, we suggest using an exact Wilcoxon rank sum test. Nonparametric bootstrap paired t-test also provided better performance than other alternatives. Nonparametric bootstrap test provided benefit over exact Kruskal-Wallis test. We suggest using nonparametric bootstrap test with pooled resampling method for comparing paired or unpaired means and for validating the one way analysis of variance test results for non-normal data in small sample size studies. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Quantitative Analysis of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography Identifies Novel Prognostic Imaging Biomarkers in Locally Advanced Pancreatic Cancer Patients Treated With Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Cui, Yi [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan); Song, Jie; Pollom, Erqi; Alagappan, Muthuraman [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Shirato, Hiroki [Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan); Chang, Daniel T.; Koong, Albert C. [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Stanford Cancer Institute, Stanford, California (United States); Li, Ruijiang, E-mail: rli2@stanford.edu [Department of Radiation Oncology, Stanford University, Palo Alto, California (United States); Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan); Stanford Cancer Institute, Stanford, California (United States)

    2016-09-01

    Purpose: To identify prognostic biomarkers in pancreatic cancer using high-throughput quantitative image analysis. Methods and Materials: In this institutional review board–approved study, we retrospectively analyzed images and outcomes for 139 locally advanced pancreatic cancer patients treated with stereotactic body radiation therapy (SBRT). The overall population was split into a training cohort (n=90) and a validation cohort (n=49) according to the time of treatment. We extracted quantitative imaging characteristics from pre-SBRT {sup 18}F-fluorodeoxyglucose positron emission tomography, including statistical, morphologic, and texture features. A Cox proportional hazard regression model was built to predict overall survival (OS) in the training cohort using 162 robust image features. To avoid over-fitting, we applied the elastic net to obtain a sparse set of image features, whose linear combination constitutes a prognostic imaging signature. Univariate and multivariate Cox regression analyses were used to evaluate the association with OS, and concordance index (CI) was used to evaluate the survival prediction accuracy. Results: The prognostic imaging signature included 7 features characterizing different tumor phenotypes, including shape, intensity, and texture. On the validation cohort, univariate analysis showed that this prognostic signature was significantly associated with OS (P=.002, hazard ratio 2.74), which improved upon conventional imaging predictors including tumor volume, maximum standardized uptake value, and total legion glycolysis (P=.018-.028, hazard ratio 1.51-1.57). On multivariate analysis, the proposed signature was the only significant prognostic index (P=.037, hazard ratio 3.72) when adjusted for conventional imaging and clinical factors (P=.123-.870, hazard ratio 0.53-1.30). In terms of CI, the proposed signature scored 0.66 and was significantly better than competing prognostic indices (CI 0.48-0.64, Wilcoxon rank sum test P<1e-6

  5. Adverse events associated with fluoroscopically guided lumbosacral transforaminal epidural steroid injections.

    Science.gov (United States)

    Plastaras, Christopher; McCormick, Zachary L; Garvan, Cynthia; Macron, Donald; Joshi, Anand; Chimes, Gary; Smeal, Wesley; Rittenberg, Joshua; Kennedy, David J

    2015-10-01

    Although the types and incidence of adverse events (AEs) associated with transforaminal epidural steroid injection (TFESI) have been described, no study has used a systematic standardized questionnaire to solicit AEs from patients to capture an accurate range and incidence of complications. The aim was to systematically identify the types and incidence of AEs associated with TFESI. Additionally, this study evaluated demographic and clinical factors that may predict a higher risk of an AE. This was a retrospective cohort study from a multiphysician academic PM&R clinic. Patients, aged 19 to 89, who underwent a fluoroscopically guided TFESI for lumbosacral radicular pain between 2004 and 2007 were included. The relationship of AEs with gender, age, trainee presence, steroid type, preprocedure visual analog scale (VAS) pain score, systolic blood pressure, fluoroscopy time, and corticosteroid injectate volume was analyzed. Adverse event data were collected using a survey both immediately and at 24 to 72 hours after TFESI. Statistical analysis was performed using the chi-square, Fisher exact, or Wilcoxon rank sum two-sided tests. Logistic regression analysis was also performed. C.P. is the owner of Rehabilitation Institute of Chicago Physiatric Log & Analysis System computer software. In 1,295 consecutive patients undergoing 2,025 TFESI procedures, immediate AEs and delayed AEs occurred after 182 (9.2%) and 305 (20.0%) injections, respectively. The most common immediate AEs were: vasovagal reaction (4.2%) and interrupted procedure from intravascular flow (1.7%). Common delayed AEs included: pain exacerbation (5.0%), injection site soreness (3.9%), headache (3.9%), facial flushing/sweating (1.8%), and insomnia (1.6%). Significant associations were identified between AEs and gender, age, preprocedure VAS, steroid type, and fluoroscopy time. Trainee involvement in the procedure did not impact the complication rate. Fluoroscopically guided lumbosacral TFESI is associated

  6. Bioethics training programmes for Africa: evaluating professional and bioethics-related achievements of African trainees after a decade of Fogarty NIH investment.

    Science.gov (United States)

    Kass, Nancy E; Ali, Joseph; Hallez, Kristina; Hyder, Adnan A

    2016-09-15

    Our primary aim was to evaluate the impact of US National Institutes of Health (NIH)-funded bioethics training programmes (Fogarty bioethics training programmes, FBTPs) that trained individuals from Africa over the programme's first 10 years to examine changes between pretraining and post-training in individual achievement and to document any associations between individual, training programme and post-training accomplishments. We surveyed trainees from the 10 bioethics programmes funded by NIH Fogarty International Center from 2000 to 2011 that included African trainees. McNemar's and Wilcoxon signed rank-sum tests were used to analyse pre-post levels of general and bioethics-related professional achievement. Likelihood of specific post-training achievement outcomes was measured using logistic regression including demographic, pretraining and intratraining variables. 10 different FBTPs that trained individuals from Africa from 2000 to 2011. Of 253 eligible respondents, 171 completed the survey (response rate 67.6%). Pre-post comparisons of professional achievement indicators (eg, serving in leadership roles, teaching, publishing manuscripts); likelihood of specific post-training achievement outcomes. Post-training, respondents were significantly more likely to report serving in a leadership role, being an investigator on a research grant, serving on international committees, serving as a mentor, and publishing manuscripts than at pretraining. Post-training, significantly greater numbers of respondents reported bioethics-related achievements including being a bioethics instructor, serving on an Institutional Review Board (IRB), being an investigator on a bioethics grant and publishing bioethics-related manuscripts than pretraining. Controlling for other factors, there were no significant differences by gender in the post-training success of these participants in terms of leadership roles, being instructors, investigators on grants and holding IRB roles. African

  7. Distinguishing Failure to Cure From Complication After Penile Prosthesis Implantation.

    Science.gov (United States)

    Pineda, Miguel; Burnett, Arthur L

    2017-05-01

    A successful penile prosthesis implantation (PPI) surgery can be defined by outcomes beyond the absence of complications. To introduce the concept of failure to cure (FTC) in the context of PPI to more accurately gauge postoperative outcomes after PPI. Consecutive patients from our sexual function registry who underwent PPI from January 2011 to December 2013 were analyzed. Demographics, previous treatment of erectile dysfunction, comorbidities, social history, postoperative problems (POPs), and surgical outcomes were tabulated. Patients completed the International Index of Erection Function (IIEF) and the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaires. We defined a complication, according to the Clavien-Dindo classification, as any deviation from the ideal postoperative course that is not inherent in the procedure and does not constitute an FTC. FTC was defined as a POP that was not a complication. The χ 2 tests, t-tests, or Wilcoxon rank-sum tests were used. Patient-reported and objective outcomes after PPI. Our enrollment consisted of 185 patients, and we contacted 124 (67%). Of these, 16 (12.9%) had a POP requiring reoperation. Eight patients developed surgical complications (three infections, four erosions, and one chronic pain). Eight patients had FTC (four malpositions and four malfunctions). Factors that correlated with POPs were previous PPI, body mass index higher than 30 kg/m 2 , and previous treatment with intracorporal injections (P .05 for all comparisons). POPs after PPI surgery can be more accurately categorized using the Clavien-Dindo classification of surgical complications to more clearly distinguish surgical complications from FTC. Limitations of our study include its retrospective approach. Our series included a large proportion of patients treated for prostate cancer, which limits the generalizability of our findings. We also had a relatively short median follow-up time of 27 months. Patient-reported outcome

  8. Differences in Pediatric Pain Management by Unit Types.

    Science.gov (United States)

    O'Neal, Kelsea; Olds, Danielle

    2016-07-01

    The purpose of this study was to determine differences in pediatric pain management by unit type in hospitals across the United States. The aims were to (a) compare unit-type rates of assessment, intervention, and reassessment (AIR), and (b) describe differences in assessment tools and intervention use by unit type. The study used a cross-sectional design. A secondary analysis of 2013 data from the National Database of Nursing Quality Indicators (NDNQI®) pain AIR cycle indicator was conducted. The sample included 984 pediatric units in 390 hospitals. Data were gathered via retrospective chart review on the pain assessment tool used, presence of pain, interventions, and reassessment. Descriptive statistics and the Kruskal-Wallis one-way analysis of variance test were conducted. Post-hoc analyses included the Wilcoxon-rank sum test with Bonferroni correction. Across all units the mean unit-level percentage of patients assessed for pain was 99.6%. Of those patients assessed, surgical units had the highest average unit-level percentage of patients with pain, while Level 4 neonatal intensive care units (NICUs) had the lowest. The most commonly used assessment tool among all units was the Faces, Legs, Activity, Crying, and Consolability (FLACC) Scale. The Neonatal Pain, Agitation, and Sedation Scale (N-PASS) and Neonatal Infant Pain Scale (NIPS) specifically developed for infants were more commonly used across NICU unit types. The mean unit-level percentage of patients with pain receiving an intervention was 89.4%, and reassessment was 83.6%. Overall, pharmacologic methods were the most common pain intervention, while music was the least common. Assessments were performed routinely, yet interventions and reassessments were not. Pain AIR cycle completion varied by unit type. Pain was also widely present across many unit types, and pharmacologic methods were most frequently used. Frontline nurses are instrumental to pain management and have the ability to improve patient

  9. Can Rural Minimally Invasive Surgery Fellowships Provide Operative Experience Similar to Urban Programs?

    Science.gov (United States)

    Ryan, James Patrick; Borgert, Andrew J; Kallies, Kara J; Carlson, Lea M; McCollister, Howard; Severson, Paul A; Kothari, Shanu N

    2016-01-01

    Operative experience in rural fellowship programs is largely unknown. The 2 of the most rural minimally invasive surgery (MIS)/bariatric fellowships are located in the upper Midwest. We hypothesized that these 2 programs would offer a similar operative experience to other U.S. programs in more urban locations. The 2011 to 2012 and 2012 to 2013 fellowship case logs from 2 rural Midwest programs were compared with case logs from 23 U.S. MIS/bariatric programs. All rural Midwest fellowship graduates completed a survey describing their fellowship experience and current practice. Statistical analysis included Wilcoxon rank-sum test. Setting included the 2 rural Midwest U.S. MIS/bariatric fellowship programs. Graduates from MIS/bariatric fellowship programs participated in the study. Mean volumes for bariatric, foregut, abdominal wall, small intestine, and hepatobiliary cases for rural Midwest fellows vs. other U.S. programs were 123.8 ± 23.7 vs. 150.2 ± 49.2 (p = 0.20); 44.3 ± 19.4 vs. 66.3 ± 35.5 (p = 0.18); 48.3 ± 28.0 vs. 57.9 ± 27.8 (p = 0.58); 11.3 ± 1.9 vs. 12.0 ± 8.7 (p = 0.58); and 55.0 ± 34.8 vs. 48.1 ± 42.6 (p = 0.63), respectively. Mean endoscopy volume was significantly higher among rural Midwest fellows (451.0 ± 395.2 vs. 99.7 ± 83.4; p = 0.05). All rural Midwest fellows reported an adequate number of cases as operating surgeon during fellowship. A total of 60% of fellows currently practice in a rural area. In all, 87% and 13% reported that their fellowship training was extremely or somewhat beneficial to their current practice, respectively. Rural MIS fellowship programs offer a similar operative experience to other U.S. programs. A greater volume of endoscopy cases was observed in rural Midwest fellowships. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. Leptomeningeal failure in patients with breast cancer receiving stereotactic radiosurgery for brain metastases.

    Science.gov (United States)

    Wang, Edina C; Huang, Andrew J; Huang, Karen E; McTyre, Emory R; Lo, Hui-Wen; Watabe, Kounosuke; Metheny-Barlow, Linda; Laxton, Adrian W; Tatter, Stephen B; Strowd, Roy E; Chan, Michael D; Page, Brandi R

    2017-09-01

    Prior studies suggest a high incidence of leptomeningeal failure (LMF) in breast cancer metastatic to brain. This study examines breast cancer-specific variables affecting development of LMF and survival after Gamma-Knife Radiosurgery (GKS). Between 2000-2010, 149 (breast) and 658 other-histology patients were treated with GKS. Hormone/HER2, age, local/distant brain failure, prior craniotomy, and prior whole-brain radiotherapy (WBRT) were assessed. Median follow-up was 54months (range, 0-106). Serial MRI determined local and distant-brain failure and LMF. Statistical analysis with categorical/continuous data comparisons were done with Fisher's-exact, Wilcoxon rank-sum, log-rank tests, and Cox-Proportional Hazard models. Of 149 patients, 21 (14%) developed LMF (median time of 11.9months). None of the following predicted for LMF: Her2-status (HR=0.49, p=0.16), hormone-receptor status (HR=1.15, p=0.79), prior craniotomy (HR=1.58, p=0.42), prior WBRT (HR=1.36, p=0.55). Non-significant factors between patients that did (n=21) and did not (n=106) develop LMF included neurologic death (p=0.34) and median survival (8.6 vs 14.2months, respectively). Breast patients who had distant-failure after GKS (65/149; 43.6%) were more likely to later develop LMF (HR 4.2, p=0.005); including 15/65 (23%) patients who had distant-failure and developed LMF. Median time-to-death for patients experiencing LMF was 6.1months (IQR 3.4-7.8) from onset of LMF. Median survival from LMF to death was much longer in breast (6.1months) than in other (1.7months) histologies CONCLUSION: Breast cancer patients had a longer survival after diagnosis of LMF versus other histologies. Neither ER/PR/HER2 status, nor prior surgery or prior WBRT predicted for development of LMF in breast patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Prevention of Type 2 Diabetes by lifestyle intervention in an Australian primary health care setting: Greater Green Triangle (GGT Diabetes Prevention Project

    Directory of Open Access Journals (Sweden)

    Bunker Stephen

    2007-09-01

    Full Text Available Abstract Background Randomised controlled trials demonstrate a 60% reduction in type 2 diabetes incidence through lifestyle modification programmes. The aim of this study is to determine whether such programmes are feasible in primary health care. Methods An intervention study including 237 individuals 40–75 years of age with moderate or high risk of developing type 2 diabetes. A structured group programme with six 90 minute sessions delivered during an eight month period by trained nurses in Australian primary health care in 2004–2006. Main outcome measures taken at baseline, three, and 12 months included weight, height, waist circumference, fasting plasma glucose and lipids, plasma glucose two hours after oral glucose challenge, blood pressure, measures of psychological distress and general health outcomes. To test differences between baseline and follow-up, paired t-tests and Wilcoxon rank sum tests were performed. Results At twelve months participants' mean weight reduced by 2.52 kg (95% confidence interval 1.85 to 3.19 and waist circumference by 4.17 cm (3.48 to 4.87. Mean fasting glucose reduced by 0.14 mmol/l (0.07 to 0.20, plasma glucose two hours after oral glucose challenge by 0.58 mmol/l (0.36 to 0.79, total cholesterol by 0.29 mmol/l (0.18 to 0.40, low density lipoprotein cholesterol by 0.25 mmol/l (0.16 to 0.34, triglycerides by 0.15 mmol/l (0.05 to 0.24 and diastolic blood pressure by 2.14 mmHg (0.94 to 3.33. Significant improvements were also found in most psychological measures. Conclusion This study provides evidence that a type 2 diabetes prevention programme using lifestyle intervention is feasible in primary health care settings, with reductions in risk factors approaching those observed in clinical trials. Trial Number Current Controlled Trials ISRCTN38031372

  12. Intravesical botulinum toxin-A injections reduce bladder pain of interstitial cystitis/bladder pain syndrome refractory to conventional treatment - A prospective, multicenter, randomized, double-blind, placebo-controlled clinical trial.

    Science.gov (United States)

    Kuo, Hann-Chorng; Jiang, Yuan-Hong; Tsai, Yao-Chou; Kuo, Yuh-Chen

    2016-06-01

    Intravesical onabotulinumtoxinA (BoNT-A) injection is a beneficial treatment for interstitial cystitis/bladder pain syndrome (IC/BPS), yet its therapeutic efficacy remains to be validated. This study tests efficacy and safety of intravesical BoNT-A injections for treatment of IC/BPS. A multicenter, randomized, double-blind, placebo-controlled trial in patients with IC/BPS refractory to conventional treatment. Patients were randomized in a 2:1 ratio to hydrodistention plus suburothelial injections of BoNT-A 100 U (Botox group) or the equivalent amount of normal saline (N/S group). The primary endpoint was a decrease in pain assessed using a visual analog scale (VAS) at week 8 after treatment. Secondary endpoints included voiding diary and urodynamic variables. The Wilcoxon sign rank and rank sum tests were used for statistical analyses. A total of 60 patients (8 males, 52 females, age 50.8 ± 13.9 years) including 40 in the Botox and 20 in the N/S groups were enrolled. At week 8, a significantly greater reduction of pain was observed in the Botox group compared to the N/S group (-2.6 ± 2.8 vs. -0.9 ±  2.2, P = 0.021). The other variables did not differ significantly between groups except for cystometric bladder capacity, which was increased significantly in the Botox group. The overall success rates were 63% (26/40) in the Botox group and 15% (3/20) in the N/S group (P = 0.028). Adverse events did not differ between the groups. Intravesical injections of 100 U of BoNT-A effectively reduced bladder pain symptoms in patients with IC/BPS. The adverse events were acceptable. Neurourol. Urodynam. 35:609-614, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  13. Comparison of video, optical, and direct laryngoscopy by experienced tactical paramedics.

    Science.gov (United States)

    Yun, Brian J; Brown, Calvin A; Grazioso, Christopher J; Pozner, Charles N; Raja, Ali S

    2014-01-01

    While optical and video laryngoscopy have been studied in the emergency department, the operating room, and the routine prehospital setting, their efficacy in the tactical environment--in which operator safety is as important as intubation success--has not been evaluated. This study compared direct laryngoscopes to optical (AirTraq) and video (King Vision) laryngoscopes in a simulated tactical setting. This prospective institutional review board-approved simulation study evaluated each of the laryngoscopes in the hands of seven experienced tactical paramedics. After a one-hour training session, each tactical paramedic used each of the laryngoscopes, in a random order, on each of four different airway manikins. A tactical environment was simulated using auditory and visual immersion, and the intubations occurred on the ground with the paramedics in full tactical gear. Outcomes included time to successful ventilation, first-pass success rate, Cormack-Lehane grade, and intubator head height during the intubation. Statistical analysis included chi-squared and Wilcoxon rank sum tests, and multivariate logistic regression was performed to determine contributing factors to outcomes with significant variation. A total of 84 intubations were performed by seven tactical paramedics. While there were no significant differences in time to successful ventilation or first-pass success rate, the optical and video laryngoscopes had significantly better Cormack-Lehane grades, defined as grade I or II (100% for both compared to 85.7%), while direct laryngoscopy resulted in significantly less maximum vertical exposure of the intubator (51.82 cm compared to AirTraq's 56.64 cm and King Vision's 56.13 cm). Video and optical laryngoscopes can be used successfully by experienced tactical paramedics in a simulated tactical setting. The King Vision and AirTraq resulted in improved Cormack-Lehane glottic views but similar times to ventilation and first-pass success compared to direct

  14. Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation

    International Nuclear Information System (INIS)

    Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

    2015-01-01

    Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of D mean < 4 Gy in these two cohorts. Twenty consecutive patients underwent CT simulation both free breathing (FB) and DIBH. Patients were grouped into two cohorts: WBRT (n = 11) and B/CWRT + RNI (n = 9). 3D-conformal plans were developed and FB was compared to DIBH for each cohort using Wilcoxon signed-rank tests for continuous variables and McNemar’s test for discrete variables. The percent relative reduction conferred by DIBH in mean heart and LAD dose, as well as lung V 20 were compared between the two cohorts using Wilcox rank-sum testing. The significance level was set at 0.05 with Bonferroni correction for multiple testing. All patients had comparable target coverage on DIBH and FB. DIBH statistically significantly reduced mean heart and LAD dose for both cohorts. Percent reduction in mean heart and LAD dose with DIBH was significantly larger in the B/CWRT + RNI cohort compared to WBRT group (relative reduction in mean heart and LAD dose: 55.9 % and 72.1 % versus 29.2 % and 43.5 %, p < 0.02). All patients in the WBRT group and five patients (56 %) in the B/CWBRT + RNI group met heart D mean <4 Gy with FB. All patients met this constraint with DIBH. All patients receiving WBRT met D mean Heart < 4 Gy on FB, while only slightly over

  15. Thoracoscopic Nuss procedure for young adults with pectus excavatum: excellent midterm results and patient satisfaction.

    Science.gov (United States)

    Hanna, Waël C; Ko, Michael A; Blitz, Maurice; Shargall, Yaron; Compeau, Christopher G

    2013-09-01

    Chest wall remodeling by substernal placement of a Nuss bar is the treatment of choice for children with pectus excavatum; however, it has not yet gained widespread acceptance in adults. We demonstrate that thoracoscopic Nuss bar insertion in young adults is safe and leads to excellent results. Adult patients who underwent thoracoscopic Nuss bar insertion at one institution between 2006 and 2012 were identified. Data on demographics, postoperative outcomes, quality of life, and cosmetic satisfaction was collected. A validated single-step quality of life survey was administered to patients. Student's t test and the Wilcoxon rank sum test were used for statistical analysis. Seventy-three patients (65 male, 8 female) with a median age of 20 years (range, 16 to 51) were included. The median follow-up was 44.6 months (range, 36.9 to 73.26). Most patients (59 of 73, 81%) had one bar placed. The median length of hospital stay was 5 days (range, 3 to 9) and the median duration of epidural anesthesia was 3 days (range, 0 to 7). There were 4 reoperations (5.5%) in the immediate postoperative period: 2 for bar displacement and 2 for poor cosmesis. All reoperations were performed thoracoscopically. Other postoperative complications included pneumothorax (3 of 73, 4.1%) and ileus (1 of 73, 1.3%). Fifty-one patients participated in a quality-of-life survey (73% response rate). The mean self-esteem score improved from 4.6 of 10 preoperatively to 6.5 of 10 postoperatively (p=0.002). The social impact of the pectus deformity became less significant (mean preoperative score 3.6, mean postoperative score 2.8, p=0.02). The severity of initial postoperative pain was much improved on follow-up. The vast majority of patients (41 of 51, 80%) were satisfied with the cosmetic result, and 96% (49 of 51) would opt to have the surgery again. For young adults who wish to correct their pectus deformity, a thoracoscopic Nuss procedure is safe and results in a high rate of patient satisfaction

  16. Cross-Calibration and Comparison of Variability in Two Bone Densitometers in a Research Setting: The Framingham Experience

    Science.gov (United States)

    Gagnon, David R.; McLean, Robert R.; Hannan, Marian T.; Cupples, L. Adrienne; Hogan, Mary; Kiel, Douglas P.

    2010-01-01

    New technology introduced over time results in changes in densitometers during longitudinal studies of bone mineral density (BMD). This requires that a cross-calibration process be completed to translate measurements from the old densitometer to the new one. Previously described cross-calibration methods for research settings have collected single measures on each densitometer and used linear regression to estimate cross-calibration corrections. Thus, these methods may produce corrections that have limited precision and underestimate the variability in converted BMD values. Furthermore, most prior studies have included small samples recruited from specialized populations. Increasing the sample size, obtaining multiple measures on each machine, and utilizing linear mixed models to account for between- and within-subject variability may improve cross-calibration estimates. The purpose of this study was to conduct an in vivo cross-calibration of a Lunar DPX-L with a Lunar Prodigy densitometer using a sample of 249 healthy volunteers who were scanned twice on each densitometer, without repositioning, at both the femur and spine. Scans were analyzed using both automated and manual placement of regions of interest. Wilcoxon rank-sum tests and Bland-Altman plots were used to examine possible differences between repeat scans within and across densitometers. We used linear mixed models to determine the cross-calibration equations for the femoral neck, trochanter, total hip and lumbar spine (L2-L4) regions. Results using automated and manual placement of the regions of interest did not differ significantly The DPX–L exhibited larger median absolute differences in repeat scans for femoral neck [0.016 vs. 0.012, p=0.1] and trochanter [0.011 vs. 0.009, p=0.06] BMD values compared to the Prodigy. The Bland-Altman plots revealed no statistically significant linear relation between the difference in paired measures between machines and mean BMD. In our large sample of healthy

  17. Trends in the use of perioperative chemotherapy for localized and locally advanced muscle-invasive bladder cancer: a sign of changing tides.

    Science.gov (United States)

    Reardon, Zachary D; Patel, Sanjay G; Zaid, Harras B; Stimson, C J; Resnick, Matthew J; Keegan, Kirk A; Barocas, Daniel A; Chang, Sam S; Cookson, Michael S

    2015-01-01

    Despite the documented survival benefit conferred by neoadjuvant (NAC) and adjuvant chemotherapy (AC), there has been a slow adoption of guideline recommendations for the use of perioperative chemotherapy (POC) in patients with muscle-invasive bladder cancer (MIBC). To evaluate temporal trends in POC utilization and identify factors influencing POC delivery in a representative cohort of patients with MIBC. Retrospective cohort study identifying factors associated with receipt of POC and evaluating temporal changes in NAC and AC utilization. We included patients from the National Cancer Data Base (NCDB) with no prior malignancy who ultimately underwent radical cystectomy for ≥ cT2/cN0/cM0 MIBC between 2006 and 2010. Relationships between demographic and hospital factors and the likelihood of receiving POC were evaluated using Pearson chi-square and Wilcoxon rank-sum tests, and multivariable logistic regression. Temporal changes in NAC and AC use were detected using a linear test of trend. A total of 5692 patients met our inclusion criteria. POC use increased from 29.5% in 2006 to 39.8% in 2010 (p < 0.001). NAC use increased from 10.1% in 2006 to 20.8% in 2010 (p = 0.005); AC remained stable between 18.1% and 21.3% (p = 0.68). Multivariable modeling revealed advanced age, increasing comorbidity, lack of insurance, increased travel distance, geographic location outside the northeastern United States, and lower income as negatively associated with POC receipt (all p < 0.05). Limitations include retrospective design and potential sampling bias, excluding patients treated at non-NCDB facilities. POC use for MIBC increased from 2006 to 2010, with this increase disproportionately due to rising NAC utilization. Nonetheless, there is persistent variation in the likelihood of receiving POC secondary to nonclinical factors. When retrospectively analyzing a representative cohort of patients undergoing radical cystectomy for muscle-invasive bladder cancer between 2006 and 2010

  18. Investigation on the value of spectral CT imaging in diagnosis of benign and malignant thyroid nodules

    International Nuclear Information System (INIS)

    Li Hongwen; Liu Bin; Wu Xingwang; Wang Wanqin; Liu Wendong

    2014-01-01

    Objective: To explore the value of gemstone spectral imaging (GSI) in the detection and differential diagnosis of benign and malignant thyroid nodules. Methods: The spectral CT images in 88 patients with thyroid nodules were analyzed retrospectively. All the patients underwent spectral CT scanning, including 33 patients undergoing biphase enhanced CT imaging. Nodules were divided into benign and malignant ones according to histopathologic results. The iodine concentration, slope of spectral curve, effective atomic number in non-enhanced and enhanced scanning were compared between benign and malignant group by the Wilcoxon rank sum test, respectively. The optimal iodine concentration threshold to predict malignancy was obtained by receiver operating characteristic curve (ROC), sensitivity and specificity were achieved. Results: A total of 106 nodules were detected, including 76 benign and 30 malignant nodules. In non-contrast CT imaging, the average iodine concentration, slope of spectral curve, effective atomic number of were 2.35 × 100 μg/ml, 0.29 and 7.71 for benign group: -0.51 × 100 μg/ml, -0.06 and 7.52 for malignant group (Z value were -3.072, -3.107 and -3.055, respectively; P<0.05). In the arterial phase, the average iodine concentration, slope of spectral curve, effective atomic number of the two group were 27.22 × 100 μg/ml, 3.23 and 9.10 for benign group; 18.81 × 100 μg/ml, 2.24 and 8.69 for malignant group (Z value were -2.582, -2.582 and -2.564, respectively; P<0.05). In venous phase,no significant difference was found for each parameter between the two groups (P>0.05). The optimal iodine concentration to predict malignancy was -0.35 × 100 μg/ml in non-enhanced phase with 56.7% sensitivity and 73.7% specificity. The optimal iodine concentration was 22.91 × 100 μg/ml in arterial phase, with 76.2% sensitivity and 75.0% specificity. Using iodine concentration to predict malignancy in both non-contrast phase and arterial phase, the sensitivity

  19. {sup 18}F-alfatide PET/CT may predict short-term outcome of concurrent chemoradiotherapy in patients with advanced non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Luan, Xiaohui [Shandong Cancer Hospital affiliated to Shandong University, Department of Radiation Oncology, Jinan, Shandong (China); University of Jinan-Shandong Academy of Medical Sciences, School of Medicine and Life Sciences, Jinan (China); Huang, Yong; Sun, Xiaorong; Ma, Li; Teng, Xuepeng; Lu, Hong [Shandong Cancer Hospital affiliated to Shandong University, Department of Radiology, Jinan, Shandong (China); Gao, Song [Jining Infectious Diseases Hospital, Department of Oncology, Jining, Shandong (China); Wang, Suzhen; Yu, Jinming; Yuan, Shuanghu [Shandong Cancer Hospital affiliated to Shandong University, Department of Radiation Oncology, Jinan, Shandong (China)

    2016-12-15

    The study aims to investigate the role of {sup 18}F-alfatide positron emission tomography/computed tomography (PET/CT) in predicting the short-term outcome of concurrent chemoradiotherapy (CCRT) in patients with advanced non-small cell lung cancer (NSCLC). Eighteen patients with advanced NSCLC had undergone {sup 18}F-alfatide PET/CT scans before CCRT and PET/CT parameters including maximum and mean standard uptake values (SUV{sub max}/SUV{sub mean}), peak standard uptake values (SUV{sub peak}) and tumor volume (TV{sub PET} and TV{sub CT}) were obtained. The SUV{sub max} of tumor and normal tissues (lung, blood pool and muscle) were measured, and their ratios were denoted as T/NT (T/NT{sub lung}, T/NT{sub blood} and T/NT{sub muscle}). Statistical methods included the Two-example t test, Wilcoxon rank-sum test, Receiver-operating characteristic (ROC) curve analysis and logistic regression analyses. We found that SUV{sub max}, SUV{sub peak}, T/NT{sub lung}, T/NT{sub blood} and T/NT{sub muscle} were higher in non-responders than in responders (P = 0.0024, P = 0.016, P < 0.001, P = 0.003, P = 0.004). According to ROC curve analysis, the thresholds of SUV{sub max}, SUV{sub peak}, T/NT{sub lung}, T/NT{sub blood} and T/NT{sub muscle} were 5.65, 4.46, 7.11, 5.41, and 11.75, respectively. The five parameters had high sensitivity, specificity and accuracy in distinguishing non-responders and responders. Multivariate logistic regression analyses showed that T/NT{sub lung} was an independent predictor of the short-term outcome of CCRT in patients with advanced NSCLC (P = 0.032). {sup 18}F-alfatide PET/CT may be useful in predicting the short-term outcome of CCRT in patients with advanced NSCLC. (orig.)

  20. Evidence of cardiac involvement in the fetal inflammatory response syndrome: disruption of gene networks programming cardiac development in nonhuman primates.

    Science.gov (United States)

    Mitchell, Timothy; MacDonald, James W; Srinouanpranchanh, Sengkeo; Bammler, Theodor K; Merillat, Sean; Boldenow, Erica; Coleman, Michelle; Agnew, Kathy; Baldessari, Audrey; Stencel-Baerenwald, Jennifer E; Tisoncik-Go, Jennifer; Green, Richard R; Gale, Michael J; Rajagopal, Lakshmi; Adams Waldorf, Kristina M

    2018-04-01

    Most early preterm births are associated with intraamniotic infection and inflammation, which can lead to systemic inflammation in the fetus. The fetal inflammatory response syndrome describes elevations in the fetal interleukin-6 level, which is a marker for inflammation and fetal organ injury. An understanding of the effects of inflammation on fetal cardiac development may lead to insight into the fetal origins of adult cardiovascular disease. The purpose of this study was to determine whether the fetal inflammatory response syndrome is associated with disruptions in gene networks that program fetal cardiac development. We obtained fetal cardiac tissue after necropsy from a well-described pregnant nonhuman primate model (pigtail macaque, Macaca nemestrina) of intrauterine infection (n=5) and controls (n=5). Cases with the fetal inflammatory response syndrome (fetal plasma interleukin-6 >11 pg/mL) were induced by either choriodecidual inoculation of a hypervirulent group B streptococcus strain (n=4) or intraamniotic inoculation of Escherichia coli (n=1). RNA and protein were extracted from fetal hearts and profiled by microarray and Luminex (Millipore, Billerica, MA) for cytokine analysis, respectively. Results were validated by quantitative reverse transcriptase polymerase chain reaction. Statistical and bioinformatics analyses included single gene analysis, gene set analysis, Ingenuity Pathway Analysis (Qiagen, Valencia, CA), and Wilcoxon rank sum. Severe fetal inflammation developed in the context of intraamniotic infection and a disseminated bacterial infection in the fetus. Interleukin-6 and -8 in fetal cardiac tissues were elevated significantly in fetal inflammatory response syndrome cases vs controls (P1.5-fold change, Pfetal heart (analysis of variance). Altered expression of select genes was validated by quantitative reverse transcriptase polymerase chain reaction that included several with known functions in cardiac injury, morphogenesis, angiogenesis

  1. 76 FR 76436 - Certain Communication Equipment, Components Thereof, and Products Containing the Same, Including...

    Science.gov (United States)

    2011-12-07

    ..., Components Thereof, and Products Containing the Same, Including Power Over Ethernet Telephones, Switches... products containing the same, including power over ethernet telephones, switches, wireless access points... certain communication equipment, components thereof, and products containing the same, including power...

  2. Stromal Gene Expression is Predictive for Metastatic Primary Prostate Cancer.

    Science.gov (United States)

    Mo, Fan; Lin, Dong; Takhar, Mandeep; Ramnarine, Varune Rohan; Dong, Xin; Bell, Robert H; Volik, Stanislav V; Wang, Kendric; Xue, Hui; Wang, Yuwei; Haegert, Anne; Anderson, Shawn; Brahmbhatt, Sonal; Erho, Nicholas; Wang, Xinya; Gout, Peter W; Morris, James; Karnes, R Jeffrey; Den, Robert B; Klein, Eric A; Schaeffer, Edward M; Ross, Ashley; Ren, Shancheng; Sahinalp, S Cenk; Li, Yingrui; Xu, Xun; Wang, Jun; Wang, Jian; Gleave, Martin E; Davicioni, Elai; Sun, Yinghao; Wang, Yuzhuo; Collins, Colin C

    2018-04-01

    Clinical grading systems using clinical features alongside nomograms lack precision in guiding treatment decisions in prostate cancer (PCa). There is a critical need for identification of biomarkers that can more accurately stratify patients with primary PCa. To identify a robust prognostic signature to better distinguish indolent from aggressive prostate cancer (PCa). To develop the signature, whole-genome and whole-transcriptome sequencing was conducted on five PCa patient-derived xenograft (PDX) models collected from independent foci of a single primary tumor and exhibiting variable metastatic phenotypes. Multiple independent clinical cohorts including an intermediate-risk cohort were used to validate the biomarkers. The outcome measurement defining aggressive PCa was metastasis following radical prostatectomy. A generalized linear model with lasso regularization was used to build a 93-gene stroma-derived metastasis signature (SDMS). The SDMS association with metastasis was assessed using a Wilcoxon rank-sum test. Performance was evaluated using the area under the curve (AUC) for the receiver operating characteristic, and Kaplan-Meier curves. Univariable and multivariable regression models were used to compare the SDMS alongside clinicopathological variables and reported signatures. AUC was assessed to determine if SDMS is additive or synergistic to previously reported signatures. A close association between stromal gene expression and metastatic phenotype was observed. Accordingly, the SDMS was modeled and validated in multiple independent clinical cohorts. Patients with higher SDMS scores were found to have worse prognosis. Furthermore, SDMS was an independent prognostic factor, can stratify risk in intermediate-risk PCa, and can improve the performance of other previously reported signatures. Profiling of stromal gene expression led to development of an SDMS that was validated as independently prognostic for the metastatic potential of prostate tumors. Our

  3. A preliminary study comparing attitudes toward hospice referral between African American and white American primary care physicians.

    Science.gov (United States)

    Ache, Kevin A; Shannon, Robert P; Heckman, Michael G; Diehl, Nancy N; Willis, Floyd B

    2011-05-01

    End-of-life (EOL) decision making is an integral component of high-quality health care. Factors influencing individual primary care physicians (PCPs) can affect their perspectives and referral preferences for EOL care. Numerous barriers have been cited, including patient and family readiness, physicians' comfort with discussing death, and the pursuit of a cure. This study explores another barrier by examining physician ethnicity and comparing the attitudes toward hospice referral between African American and white American primary care providers (PCPs). Training PCPs to efficiently transition from a curative model of care to a palliative model of care has the potential to increase the level of appropriate EOL care, increase hospice referral, and enhance patient and provider satisfaction; it is also fiscally prudent. This preliminary study aims to compare attitudes toward hospice referral and physicians' personal experiences with hospice between African American and white American PCPs. The survey tool was developed by PCPs at the Mayo Clinic Florida after a full literature review and consultation with hospice physicians, oncology specialists, and primary care colleagues from the residency programs at Mayo Minnesota and Mayo Arizona, with input from the Mayo Survey Office, and distributed to all physicians and residents in the departments of Family Medicine at via Mayo's intranet; Mayo's Midwest Regional Practices (245 physicians) received the survey via standard mail. The survey consisted of 17 questions regarding attitudes toward hospice referral and the one question regarding physicians' personal experience with hospice. The final sample size consisted of 167 white American physicians and 46 African American physicians. Responses were compared using a Wilcoxon rank sum test. P values ≤ 0.05 were considered statistically significant. All statistical analyses were performed using the SAS software package (SAS Institute, Cary, North Carolina). The

  4. MR imaging of the biliary tract with Gd-EOB-DTPA: Effect of liver function on signal intensity

    Energy Technology Data Exchange (ETDEWEB)

    Takao, Hidemasa, E-mail: takaoh-tky@umin.ac.jp [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Akai, Hiroyuki; Tajima, Taku [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Kiryu, Shigeru [Department of Radiology, Institute of Medical Science, University of Tokyo, 74-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639 (Japan); Watanabe, Yasushi [Department of Radiological Technology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Imamura, Hiroshi [Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-8431 (Japan); Akahane, Masaaki; Yoshioka, Naoki [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Kokudo, Norihiro [Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Ohtomo, Kuni [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan)

    2011-02-15

    Objective: To quantitatively evaluate the signal intensity of the biliary tract in gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging and to investigate the effect of liver function on the signal intensity of the biliary tract. Materials and methods: A total of 32 patients with and without chronic liver disease (normal liver group, n = 15; chronic liver disease group, n = 17) were included in this study. All patients were prospectively enrolled for evaluation of known or suspected focal liver lesions. In the chronic liver disease group, the etiologies were chronic hepatitis C virus infection (n = 12) and chronic hepatitis B virus infection (n = 5). The median Child-Pugh score was 5 (range, 5-7). Each patient received the standard dose of Gd-EOB-DTPA (0.025 mmol/kg of body weight). Post-contrast T1-weighted MR images were obtained at 5, 10, 15, 20, 25, and 30 min after administration of Gd-EOB-DTPA. Maximum signal intensities (SIs) of the right and left hepatic ducts, common hepatic duct, and common bile duct were measured. Relative signal intensity was calculated as follows: relative SI = maximum SI{sub bileduct}/mean SI{sub muscle}. Serum albumin level, serum total bilirubin level, prothrombin time, indocyanine green retention rate at 15 min (ICG-R15), and estimated glomerular filtration rate were entered into regression analysis. Results: The signal intensity of the bile duct reached a peak 30 min after administration of Gd-EOB-DTPA. The mean relative signal intensity of the right and left hepatic ducts at the peak time point was not significantly different between the two groups, while increase in signal intensity was delayed in the chronic liver disease group. The mean relative signal intensity of the common hepatic duct and that of the common bile duct at the peak time point were significantly different between the two groups (Wilcoxon rank-sum test, P = 0.03, respectively). Stepwise regression

  5. An enhanced recovery program for bariatric surgical patients significantly reduces perioperative opioid consumption and postoperative nausea.

    Science.gov (United States)

    King, Adam B; Spann, Matthew D; Jablonski, Patrick; Wanderer, Jonathan P; Sandberg, Warren S; McEvoy, Matthew D

    2018-02-13

    Patients frequently remain in the hospital after bariatric surgery due to pain, nausea, and inability to tolerate oral intake. Enhanced recovery after surgery (ERAS) concepts address these perioperative complications and therefore improve length of stay for bariatric surgery patients. To determine if ERAS concepts increase the proportion of patients discharged on postoperative day 1. Secondary objectives included mean length of stay, perioperative opioid use, emergency department visits, and readmissions. A large metropolitan university tertiary hospital. A quantitative before and after study was conducted for patients undergoing bariatric surgical patients. Data were collected surrounding length of stay, perioperative opioid consumption, antiemetic therapy requirements postoperatively, multimodal analgesia compliance, emergency department visits, and hospital readmission rates. Wilcoxon rank-sum and χ 2 test were used to compare continuous and categorical variables, respectively. A secondary analysis was performed using Aligned Rank Transformation and Cochran-Mantel-Haenszel χ 2 tests to account for an increase in sleeve gastrectomies in the intervention group. The 2 groups had clinically similar baseline characteristics. Comparison group (N = 366) and ERAS group (N = 715) patients underwent a primary bariatric surgery procedure. There was an increase in the number of patients undergoing a laparoscopic sleeve gastrectomy in the intervention group. After accounting for this increase, the percentage of patients discharged on postoperative day 1 was unchanged (79.8% non-ERAS versus 83.1% ERAS, P = .52). ERAS length of stay was statistically significantly lower for gastric bypass (P<.001) and robotic gastric bypass (P = .01). Perioperative opioid consumption was reduced (41.0 versus 16.2 morphine equivalents, P<0.001), and fewer ERAS patients required postoperative antiemetics (68.8% versus 46.2%, P<.001). Emergency department visits at 7 days were reduced (6

  6. [Predictors factors for the extubation failure in two or more times among preterm newborn].

    Science.gov (United States)

    Tapia-Rombo, Carlos Antonio; De León-Gómez, Noé; Ballesteros-Del-Olmo, Julio César; Ruelas-Vargas, Consuelo; Cuevas-Urióstegui, María Luisa; Castillo-Pérez, José Juan

    2010-01-01

    With the ventilatory mechanical attendance has been prolonged the life of the preterm newborn (PTNB) critically sick and during that lapse many occasions it is necessary reintubation to PTNB in two or more times with the subsequent damage that makes enter to the patient to a vicious circle with more damage during the same reintubated. The objective of this study was to determine the factors that predict the extubation failure among PTNB from 28 to 36 weeks of gestational age in two or more times. It was considered extubation failure when in the first 72 hours of being had extubated the patient; there was reintubation necessity, independent of the cause that originated it. For the second extubation or more took the same approach. During the period of September to December of the 2004 were included in retrospective study to all PTNB that were interned in one hospital of third level that fulfilled the inclusion approaches (one study published where we take account the first extubation failure) and in retrolective study to the patients of the same hospital of January to October of the 2006. They were formed two groups, group A of cases (who failed in extubation two or more times) and the B of controls (who failed in extubation for the first time). The descriptive statistic and the inferential through of Student t test or Mann-Whitney U or rank sum test Wilcoxon, in suitable case; Chi-square or Fisher's exact test was used. Odds ratio (OR) and multivariate analysis for to study predictors factors for the extubation failure was employed. Statistical significance was considered at p 2, OR 5.3, IC to 95% of 1.3-21.4 (P = 0.02). In the bronchoscopy study they were some anatomical alterations that they explained the extubation failure in the second time. We conclude that it is important to plan an extubation in the PTNB, when there has already been a previous failure, and to avoid the well-known predictors factors for extubation failure as much as possible in the extubation

  7. Time-Efficiency Analysis Comparing Digital and Conventional Workflows for Implant Crowns: A Prospective Clinical Crossover Trial.

    Science.gov (United States)

    Joda, Tim; Brägger, Urs

    2015-01-01

    To compare time-efficiency in the production of implant crowns using a digital workflow versus the conventional pathway. This prospective clinical study used a crossover design that included 20 study participants receiving single-tooth replacements in posterior sites. Each patient received a customized titanium abutment plus a computer-aided design/computer-assisted manufacture (CAD/CAM) zirconia suprastructure (for those in the test group, using digital workflow) and a standardized titanium abutment plus a porcelain-fused-to-metal crown (for those in the control group, using a conventional pathway). The start of the implant prosthetic treatment was established as the baseline. Time-efficiency analysis was defined as the primary outcome, and was measured for every single clinical and laboratory work step in minutes. Statistical analysis was calculated with the Wilcoxon rank sum test. All crowns could be provided within two clinical appointments, independent of the manufacturing process. The mean total production time, as the sum of clinical plus laboratory work steps, was significantly different. The mean ± standard deviation (SD) time was 185.4 ± 17.9 minutes for the digital workflow process and 223.0 ± 26.2 minutes for the conventional pathway (P = .0001). Therefore, digital processing for overall treatment was 16% faster. Detailed analysis for the clinical treatment revealed a significantly reduced mean ± SD chair time of 27.3 ± 3.4 minutes for the test group compared with 33.2 ± 4.9 minutes for the control group (P = .0001). Similar results were found for the mean laboratory work time, with a significant decrease of 158.1 ± 17.2 minutes for the test group vs 189.8 ± 25.3 minutes for the control group (P = .0001). Only a few studies have investigated efficiency parameters of digital workflows compared with conventional pathways in implant dental medicine. This investigation shows that the digital workflow seems to be more time-efficient than the

  8. Pig Farmers’ Homes Harbor More Diverse Airborne Bacterial Communities Than Pig Stables or Suburban Homes

    Directory of Open Access Journals (Sweden)

    Ditte V. Vestergaard

    2018-05-01

    Full Text Available Airborne bacterial communities are subject to conditions ill-suited to microbial activity and growth. In spite of this, air is an important transfer medium for bacteria, with the bacteria in indoor air having potentially major consequences for the health of a building’s occupants. A major example is the decreased diversity and altered composition of indoor airborne microbial communities as a proposed explanation for the increasing prevalence of asthma and allergies worldwide. Previous research has shown that living on a farm confers protection against development of asthma and allergies, with airborne bacteria suggested as playing a role in this protective effect. However, the composition of this beneficial microbial community has still not been identified. We sampled settled airborne dust using a passive dust sampler from Danish pig stables, associated farmers’ homes, and from suburban homes (267 samples in total and carried out quantitative PCR measurements of bacterial abundance and MiSeq sequencing of the V3–V4 region of bacterial 16S rRNA genes found in these samples. Airborne bacteria had a greater diversity and were significantly more abundant in pig stables and farmers’ homes than suburban homes (Wilcoxon rank sum test P < 0.05. Moreover, bacterial taxa previously suggested to contribute to a protective effect had significantly higher relative and absolute abundance in pig stables and farmers’ homes than in suburban homes (ALDEx2 with P < 0.05, including Firmicutes, Peptostreptococcaceae, Prevotellaceae, Lachnospiraceae, Ruminococcaceae, Ruminiclostridium, and Lactobacillus. Pig stables had significantly lower airborne bacterial diversity than farmers’ homes, and there was no discernable direct transfer of airborne bacteria from stable to home. This study identifies differences in indoor airborne bacterial communities that may be an important component of this putative protective effect, while showing that pig stables

  9. Notification of Concurrence - K-25/K-27 D&D Project, ETTP - Change Number of EMWMF Waste Lots in the Waste Handling Plan for Demolition of the K-25 and K-27 Building Structures and Remaining Components Located at the ETTP, Oak Ridge, TN From Two to Three

    Energy Technology Data Exchange (ETDEWEB)

    Trice K.D.

    2009-02-11

    Section 5.1 of the approved Waste Handling Plan for Demolition ofthe K-25 and K-2 7 Building Structures and Remaining Components Located at the East Tennessee Technology Park, Oak Ridge, Tennessee (WHP) includes two Environmental Management Waste Management (EMWMF) waste lots: (1) Asbestos-contaminated roofing/transite; and (2) Construction debris, such as nonasbestos roofing, structural steel/miscellaneous metal/equipment, nonradiological piping, wood, and miscellaneous small quantities of concrete. This concurrence form adds an additional EMWMF waste lot 6.47 for lavatory sink drains. Based on an analysis of the building structure characterization data, the only individual building structure with either an analytic carcinogenic or Hazard Index (HI) sum-of-fractions (SOF) greater than 1 is the lavatory sink drains (Table 1). The HI SOF for the lavatory sink drains is 1.34 (Table 2). When all media are combined with the material of construction calculations, the HI SOF is 1.22 (Table 3). However, when the lavatory sink drains are segregated from all other media, the HI SOF is only 0.256, which is well below the EMWMF waste acceptance criteria SOF limit of 1 (Table 4). Given the large volume (124, 625 cubic yards) of other building structure media with a small HI SOF of 0.256 and the small volume (one cubic yard) of lavatory sink drains with a large HI SOF of 1.34, a separate waste lot for lavatory sink drains is recommended. Lead is the primary contributor to the large HI SOF in the lavatory sink drains. Lead in the lavatory sink drains was shown using the Wilcoxon rank-sum test statistically to have higher concentrations than all other building structure media combined. Other analytes having statistically different median concentrations in the lavatory sink drains compared to all other media are antimony, arsenic, boron, cadmium, selenium, solver, vanadium, zinc, mercury, strontium, and Uranium-233/234 (Table 5). A separate waste lot for the lavatory sink drains

  10. Value of serum GP73, AFP, and AFP-L3 in diagnosis of liver cancer and recurrence monitoring after radiofrequency ablation

    Directory of Open Access Journals (Sweden)

    ZHANG Qin

    2015-02-01

    Full Text Available ObjectiveTo explore the clinical value of three serum tumor markers, Golgi protein 73 (GP73, alpha-fetoprotein (AFP, and AFP-L3, in the diagnosis of liver cancer and recurrence monitoring after radio frequency ablation. MethodsA total of 174 patients who visited our hospital from July 2012 to October 2013 were included in the study, consisting of 86 patients with newly diagnosed liver cancer, 39 with liver cirrhosis, 29 with hepatitis, and 20 healthy controls. Among the patients with newly diagnosed liver cancer, 37 were followed up for three months after the radiofrequency ablation. Serum levels of GP73, AFP, and AFP-L3 were measured by ELISA, electrochemiluminescence, and affinity adsorption chromatography, respectively. Nonparametric tests were performed on the results of serum samples from the four groups which showed skewed distribution and were represented by median (quartile interval [M(P25-P75]. Overall comparison was made by Kruskal-Wallis H test, and comparison between groups was made by Mann-Whitney U test. Pair-matching rank-sum test was performed using Wilcoxon Signed Ranks, and categorical data were analyzed by χ2 test. ResultsThe levels of GP73, AFP, and AFP-L3 in the liver cancer group were significantly higher than those in other groups (all P<0.05. The positive rates of GP73 and AFP-L3 in the liver cancer group were significantly higher than those in other groups (all P<0.05, and the positive rates of the two markers were significantly higher than that of AFP among patients with liver cancer (P<0.05. Thirty-seven patients with newly diagnosed liver cancer were reexamined three months after radiofrequency ablation, and the preoperational AFP-L3 level in the patients who had recurrence was significantly higher than that in the patients without recurrence (P<0.05. ConclusionSerum GP73, AFP, and AFP-L3 show great values in the diagnosis of liver cancer. AFP-L3 can be used as an indicator for the identification of

  11. Passing the torch: evaluating exportability of a violence intervention program.

    Science.gov (United States)

    Smith, Randi; Evans, Abigail; Adams, Christy; Cocanour, Christine; Dicker, Rochelle

    2013-08-01

    A violence intervention program (VIP) developed at our trauma center resulted in a reduction of injury recidivism to 4% from a historical rate of 16%. Our aim was to investigate the feasibility of exporting our program to another trauma center by examining rates of and identifying potential barriers to recruitment, enrollment, and impact. We hypothesized that our VIP is feasible at another trauma center and successfully meets needs associated with risk reduction. In January 2010, we introduced our VIP to another trauma center. To assess exportability of our program, we used a standard model of program evaluation for VIPs promoted by the Centers for Disease Control and Prevention. Specifically, the process and impact portions of the model evaluation were performed in this comparative analysis over a 1-year period. Recruitment, enrollment (process), and success at meeting risk reduction needs (impact) were our outcomes. This included patient and case manager characteristics in addition to rates at which eligible patients were approached and enrolled. These variables were compared using the Wilcoxon rank-sum and chi-square tests. During the study period, 155 patients were eligible for inclusion at the exported program compared with 119 at the original VIP. Rates at which eligible patients were approached at the exported program were significantly lower than the original program (44% vs 92%, P = .04). Rates at which approached patients were enrolled were also significantly lower (21% vs 55%, P = .002). The difference was associated with the time of injury and hospital length of stay because 40% of eligible patients were missed if injury occurred during a weekend and 70% were missed if the length of stay was less than or equal to 48 hours at the exported program. A cultural match between the client and case manager was assessed by race/ethnicity and language spoken; 2 of the 3 case managers at our site are Latino and bilingual and the other is black, whereas the 1 case

  12. Lung Shunt Fraction prior to Yttrium-90 Radioembolization Predicts Survival in Patients with Neuroendocrine Liver Metastases: Single-Center Prospective Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ludwig, Johannes M. [Yale University, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging (United States); Ambinder, Emily McIntosh [John Hopkins University School of Medicine, Department of Diagnostic Radiology (United States); Ghodadra, Anish [University of Pittsburgh School of Medicine, Interventional Radiology, Department of Radiology (United States); Xing, Minzhi [Yale University, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging (United States); Prajapati, Hasmukh J. [The University of Tennessee Health Science Center, Division of Interventional Radiology, Department of Radiology (United States); Kim, Hyun S., E-mail: kevin.kim@yale.edu [Yale University, Division of Interventional Radiology, Department of Radiology and Biomedical Imaging (United States)

    2016-07-15

    ObjectiveTo investigate survival outcomes following radioembolization with Yttrium-90 (Y90) for neuroendocrine tumor liver metastases (NETLMs). This study was designed to assess the efficacy of Y90 radioembolization and to evaluate lung shunt fraction (LSF) as a predictor for survival.MethodsA single-center, prospective study of 44 consecutive patients (median age: 58.5 years, 29.5 % male) diagnosed with pancreatic (52.3 %) or carcinoid (47.7 %) NETLMs from 2006 to 2012 who underwent Y90 radioembolization was performed. Patients’ baseline characteristics, including LSF and median overall survival (OS) from first Y90 radioembolization, were recorded and compared between patients with high (≥10 %) and low (<10 %) LSF. Baseline comparisons were performed using Fisher’s exact tests for categorical and Mann–Whitney U test for continuous variables. Survival was calculated using the Kaplan–Meier method. Univariate (Wilcoxon rank-sum test) and multivariate analyses (Cox Proportional Hazard Model) for risk factor analysis were performed.ResultsThere was no statistically significant difference in age, gender, race, tumor properties, or previous treatments between patients with high (n = 15) and low (n = 29) LSF. The median OS was 27.4 months (95 %CI 12.73–55.23), with 4.77 months (95 %CI 2.87–26.73) for high and 42.77 months (95 %CI 18.47–59.73) for low LSF (p = 0.003). Multivariate analysis identified high LSF (p = 0.001), total serum bilirubin >1.2 mg (p = 0.016), and lack of pretreatment with octreotide (p = 0.01) as independent prognostic factors for poorer survival. Tumor type and total radiation dose did not predict survival.ConclusionsLSF ≥10 %, elevated bilirubin levels, and lack of pretreatment with octreotide were found to be independent prognostic factors for poorer survival in patients with NETLMs.

  13. Analysis of endotoxin and endothelin-1 levels in patients with type 1 hepatorenal syndrome

    Directory of Open Access Journals (Sweden)

    GAO Baoxiu

    2014-01-01

    Full Text Available ObjectiveTo analyze the clinical data, laboratory parameters, infection rate, and serum procalcitonin (PCT and ET-1 levels of patients with cirrhotic ascites and type 1 hepatorenal syndrome (HRS and to investigate the roles of endotoxin and ET-1 in the development of HRS. MethodsBetween January 2009 and October 2012, 56 inpatients with cirrhotic ascites and type 1 HRS (HRS group and 60 inpatients with cirrhotic ascites who had normal renal function (non-HRS group were included in the study. Their general data, causes of liver cirrhosis, infection rates and types, Child-Pugh classification, systemic inflammatory response syndrome (SIRS score, and mean arterial pressure (MAP were recorded; blood samples were collected to evaluate liver and renal function and measure serum electrolyte, PCT, and ET-1 levels. The clinical data and laboratory parameters were compared between the two groups. Categorical data were analyzed by chi-square test; comparison of normally distributed continuous data between the two groups was made by independent-samples t test, and comparison of non-normally distributed continuous data between the two groups was made by Wilcoxon rank sum test. ResultsThe infection rate of HRS group (75.0% was significantly higher than that of non-HRS group (28.4% (χ2=11.91, P<0.05. The PCT and ET-1 levels and SIRS score of HRS group [8.72 (3.14, 31.68 ng/L, 13.04±2.82 pg/ml, and 2.1±1.1] were significantly higher than those of non-HRS group [0.11 (0.04, 0.45 ng/L, 5.76±1.68 pg/ml, and 0.6±0.6] (P<0.05. In addition, the HRS group had significantly higher serum urea, creatine, cystatin C, and K levels than the non-HRS group (P<0.05, while the HRS group had significantly lower Na and Cl levels than the non-HRS group (P<0.05. There were no significant differences in ALT and AST levels between the two groups (P>005. ConclusionEndotoxin causes elevated expression of ET-1, and ET-1 induces renal perfusion deficiency by

  14. [The association between aflatoxin exposure and primary hepatocellular carcinoma risks: a case-control study in Chongqing].

    Science.gov (United States)

    Zheng, C F; Zeng, H; Wang, J; Lin, H; Feng, X B; Chen, J A; Qiu, Z Q; Luo, J H; Xu, A W; Wang, L Q; Tan, Y; Chen, S; Jiang, P; Shu, W Q

    2017-06-06

    Objective: To investigate the association between aflatoxin exposure and primary hepatocellular carcinoma (PHC) development. Methods: From December 2013 to May 2016, we selected 214 patients newly diagnosed with PHC as cases, and 214 patients as controls from three hospitals in Chongqing. Cases were confirmed with PHC diagnosis standard. And cases caused by clear reasons such as drug-induced liver injury, alcoholic liver damage, fatty liver and gallstones etiology, were excluded. Controls were included with no cancer and no digestive system disease, and recruited simultaneously with cases. Cases and controls were frequency-matched (1∶1) by same gender and age (±3 years). Peripheral blood and random urine samples were collected and analyzed for serum HBsAg status by biochemistry analyzer, and serum AFB(1)-ALB adduct and urinary AFB(1)-N(7)-GUA adduct by ELISA. Basic information, living habits and history of disease for patients were obtained by questionnaires. We used wilcoxon rank sum test to compare the median of serum AFB(1)-ALB adduct and urinary AFB(1)-N(7)-GUA adduct in cases and controls. Logistic regression analyses were performed to assess risk factors for PHC, and synergism index ( S ) of aflatoxin with other factors was estimated by the method of Andersson. Results: There was no significant difference in age between PHC cases (50.74±9.67) years and controls (51.15±9.90) years. Logistic regression showed that the odds ratio of HBV infection for PHC development was 46.3 (95 % CI: 23.3-88.0). There was a significant difference in median concentrations of serum AFB(1)-ALB adduct (cases vs controls: 146.23 vs 74.42 ng/g albumin, Paflatoxin exposure with HBV, alcohol drinking, and diabetes. The S was 4.7 (95 %CI: 2.8-7.9), 3.5 (95 %CI: 1.0-12.0), and 12.4 (95 %CI: 1.8-84.2), respectively for serum AFB(1)-ALB adduct with each of the three factors mentioned, and was 1.9 (95 %CI: 1.1-3.1), 2.0 (95 %CI: 1.1-3.6), and 2.0 (95 %CI: 1.1-3.6), respectively for

  15. Night eating syndrome and its association with weight status, physical activity, eating habits, smoking status, and sleep patterns among college students.

    Science.gov (United States)

    Yahia, Najat; Brown, Carrie; Potter, Stacey; Szymanski, Hailey; Smith, Karen; Pringle, Lindsay; Herman, Christine; Uribe, Manuela; Fu, Zhuxuan; Chung, Mei; Geliebter, Allan

    2017-09-01

    Night eating syndrome (NES) is characterized by evening hyperphagia and/or nocturnal ingestion. The main objective of this study was to assess the percentage of students complying with symptoms and behaviors consistent with the diagnostic criteria for NES, and explore its association with body mass index (BMI), dietary habits, physical activity, smoking status, and sleep patterns, among a sample of college students. A cross-sectional survey was conducted among a sample of 413 undergraduate students, mean age of 20.6 ± 1.68 SD, at Central Michigan University. Students completed an online survey including demographic information and the Night Eating Diagnostic Questionnaire (NEDQ) and Pittsburgh Sleep Quality Index Questionnaire (PSQI). Participants were grouped based on self-reporting of the presence and frequency of night eating-related symptoms and behaviors related to the diagnostic criteria for NES as follows: normal, mild night eater, moderate night eater, and full-syndrome night eater. Pearson's Chi-squared, Student's t test, and Wilcoxon rank-sum test were used to test the association between students with and without any night eating behavior in relation to BMI, lifestyle variables, and sleep duration/quality. Results showed that the proportion of students complying with symptoms and behaviors consistent with full-syndrome of NES was 1.2%. There were no significant differences between students complying with symptoms and behaviors consistent with any level of NES and those without any night eating behavior regarding BMI, eating habits, physical activity, and smoking status. NES was significantly related to sleep duration (P = 0.023). Students complying with symptoms consistent with any level of NES reported shorter sleep time and had higher total PSQI score (6.73 ± 4.06) than students without the syndrome (5.61 ± 2.61) (P = 0.007). Although the percentage of students complying with full-syndrome NES was relatively low in our student sample

  16. Fatty liver incidence and predictive variables

    International Nuclear Information System (INIS)

    Tsuneto, Akira; Seto, Shinji; Maemura, Koji; Hida, Ayumi; Sera, Nobuko; Imaizumi, Misa; Ichimaru, Shinichiro; Nakashima, Eiji; Akahoshi, Masazumi

    2010-01-01

    Although fatty liver predicts ischemic heart disease, the incidence and predictors of fatty liver need examination. The objective of this study was to determine fatty liver incidence and predictive variables. Using abdominal ultrasonography, we followed biennially through 2007 (mean follow-up, 11.6±4.6 years) 1635 Nagasaki atomic bomb survivors (606 men) without fatty liver at baseline (November 1990 through October 1992). We examined potential predictive variables with the Cox proportional hazard model and longitudinal trends with the Wilcoxon rank-sum test. In all, 323 (124 men) new fatty liver cases were diagnosed. The incidence was 19.9/1000 person-years (22.3 for men, 18.6 for women) and peaked in the sixth decade of life. After controlling for age, sex, and smoking and drinking habits, obesity (relative risk (RR), 2.93; 95% confidence interval (CI), 2.33-3.69, P<0.001), low high-density lipoprotein-cholesterol (RR, 1.87; 95% CI, 1.42-2.47; P<0.001), hypertriglyceridemia (RR, 2.49; 95% CI, 1.96-3.15; P<0.001), glucose intolerance (RR, 1.51; 95% CI, 1.09-2.10; P=0.013) and hypertension (RR, 1.63; 95% CI, 1.30-2.04; P<0.001) were predictive of fatty liver. In multivariate analysis including all variables, obesity (RR, 2.55; 95% CI, 1.93-3.38; P<0.001), hypertriglyceridemia (RR, 1.92; 95% CI, 1.41-2.62; P<0.001) and hypertension (RR, 1.31; 95% CI, 1.01-1.71; P=0.046) remained predictive. In fatty liver cases, body mass index and serum triglycerides, but not systolic or diastolic blood pressure, increased significantly and steadily up to the time of the diagnosis. Obesity, hypertriglyceridemia and, to a lesser extent, hypertension might serve as predictive variables for fatty liver. (author)

  17. [18F]FDG PET/MRI vs. PET/CT for whole-body staging in patients with recurrent malignancies of the female pelvis: initial results

    International Nuclear Information System (INIS)

    Beiderwellen, Karsten; Grueneisen, Johannes; Forsting, Michael; Lauenstein, Thomas C.; Umutlu, Lale; Ruhlmann, Verena; Buderath, Paul; Aktas, Bahriye; Heusch, Philipp; Kraff, Oliver

    2015-01-01

    To evaluate the diagnostic potential of PET/MRI with [ 18 F]FDG in recurrent ovarian and cervical cancer in comparison to PET/CT. A group of 19 patients with suspected recurrence of pelvic malignancies (ovarian cancer, 11 patients; cervical cancer, 8 patients) scheduled for an [ 18 F]FDG PET/CT were subsequently enrolled for a PET/MRI. The scan protocol comprised: (1) a T1-W axial VIBE after contrast agent adminstration, (2) an axial T2-W HASTE, (3) a coronal TIRM, (4) an axial DWI, and dedicated MR sequences of the female pelvis including (5) a T1-W VIBE before contrast agent adminstration, (6) a sagittal T2-W TSE, and (7) a sagittal T1-W dynamic VIBE. The datasets (PET/CT, PET/MRI) were rated separately by two readers regarding lesion count, lesion localization, lesion conspicuity (four-point scale), lesion characterization (benign/malignant/indeterminate) and diagnostic confidence (three-point scale). All available data (histology, prior examinations, PET/CT, PET/MRI, follow-up examinations) served as standard of reference. Median values were compared using the Wilcoxon rank sum test. Metastatic lesions were present in 16 of the 19 patients. A total of 78 lesions (malignant, 58; benign, 20) were described. Both PET/CT and PET/MRI allowed correct identification of all malignant lesions and provided equivalent conspicuity (3.86 ± 0.35 for PET/CT, 3.91 ± 0.28 for PET/MRI; p > 0.05). Diagnostic confidence was significantly higher for PET/MRI in malignant (p < 0.01) and benign lesions (p < 0.05). Both PET/CT and PET/MRI offer an equivalently high diagnostic value for recurrent pelvic malignancies. PET/MRI offers higher diagnostic confidence in the discrimination of benign and malignant lesions. Considering the reduced radiation dose and superior lesion discrimination, PET/MRI may serve as a powerful alternative to PET/CT in the future. (orig.)

  18. Implementation of Computerized Physician Order Entry for Critical Patients in an Academic Emergency Department is Not Associated with a Change in Mortality Rate

    Directory of Open Access Journals (Sweden)

    Doug D. Brunette

    2013-03-01

    Full Text Available Introduction: There is limited literature on the effect of computerized physician order entry(CPOE on mortality. The objective of our study was to determine if there was a change inmortality among critically ill patients presenting to the emergency department (ED after theimplementation of a CPOE system.Methods: This was a retrospective study of all critically ill patients in the ED during the yearbefore and the year after CPOE implementation. The primary outcome measures were mortalityin the ED, after admission, and overall. Secondary outcome measures included length of stay inthe resuscitation area of the ED, length of hospital stay, and disposition following hospitalization.Patient disposition was used as a marker for neurologic function, and patients were grouped aseither being discharged to home vs. nursing home, rehabilitation center, or a long-term healthcarefacility. We analyzed data using descriptive statistics, chi- square, and Wilcoxon rank sum tests.Results: There were 2,974 critically ill patients in the year preceding CPOE and 2,969 patientsin the year following CPOE implementation. There were no differences in mortality between thetwo groups in the ED, after admission, or overall. The pre- and post-CPOE mortality rate for theED, hospital, or overall was 2.52% vs. 2.02% (P = 0.19, 95% confidence interval [CI] -0.3 to 1.3,7.8% versus 8.29% (P = 0.61, 95% CI -1.9 to 0.9, and 10.32% vs. 10.31% (P = .60, 95% CI -1.5to 1.6, respectively. There was no difference in hospital length of stay between pre- and post-CPOE patients (3 days versus 3 days, a difference of 0.05 days (95% CI -0.47 to 0.57. Lengthof stay in the ED resuscitation area was longer in the post-CPOE group (31 versus 32 minutes, adifference of -1.96 minutes (95% CI -3.4 to -0.53. More patients were discharged to home in thepre-CPOE group (66.8% versus 64.3%, a difference of 2.54% (95% CI 0.13% to 4.96%.Conclusion: The implementation of CPOE was not associated with a change

  19. Role of observation of live cases done by Japanese experts in the acquisition of ESD skills by a western endoscopist.

    Science.gov (United States)

    Draganov, Peter V; Chang, Myron; Coman, Roxana M; Wagh, Mihir S; An, Qi; Gotoda, Takuji

    2014-04-28

    To evaluate the role of observation of experts performing endoscopic submucosal dissection (ESD) in the acquisition of ESD skills. This prospective study is documenting the learning curve of one Western endoscopist. The study consisted of three periods. In the first period (pre-observation), the trainee performed ESDs in animal models in his home institution in the United States. The second period (observation) consisted of visit to Japan and observation of live ESD cases done by experts. The observation of cases occurred over a 5-wk period. During the third period (post-observation), the trainee performed ESD in animal models in a similar fashion as in the first period. Three animal models were used: live 40-50 kg Yorkshire pig, explanted pig stomach model, and explanted pig rectum model. The outcomes from the ESDs done in the animal models before and after observation of live human cases (main study intervention) were compared. Statistical analysis of the data included: Fisher's exact test to compare distributions of a categorical variable, Wilcoxon rank sum test to compare distributions of a continuous variable between the two groups (pre-observation and post-observation), and Kruskal-Wallis test to evaluate the impact of lesion location and type of model (ex-vivo vs live pig) on lesion removal time. The trainee performed 38 ESDs in animal model (29 pre-observation/9 post-observation). The removal times post-observation were significantly shorter than those pre-observation (32.7 ± 15.0 min vs 63.5 ± 9.8 min, P < 0.001). To minimize the impact of improving physician skill, the 9 lesions post-observation were compared to the last 9 lesions pre-observation and the removal times remained significantly shorter (32.7 ± 15.0 min vs 61.0 ± 7.4 min, P = 0.0011). Regression analysis showed that ESD observation significantly reduced removal time when controlling for the sequence of lesion removal (P = 0.025). Furthermore, it was also noted a trend towards decrease in

  20. Common mental disorder symptoms among patients with malaria attending primary care in Ethiopia: a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Markos Tesfaye

    Full Text Available Common Mental Disorders (CMDs are frequent among patients attending primary care. In Africa, CMDs are often misdiagnosed as physical illnesses because many of the patients complain of somatic symptoms of mental distress. We explored whether there was difference in the levels of CMD symptoms between patients with thick film confirmed and clinical cases of malaria with negative thick film in primary care.A cross-sectional comparative study was conducted on 300 adults with a clinical diagnosis of malaria in primary care centres in Jimma, Ethiopia. Patients were recruited consecutively until 100 cases of 'malaria' with a negative thick film and 200 cases of malaria with a positive thick film consented to participate. The 20-item Self-Reporting Questionnaire (SRQ-20 was used to measure CMD. The non-parametric Wilcoxon rank-sum test was used to explore the association between thick film result and CMD.Participants had a mean age of 28.2 (S.D = 10.9 years and the majority (57.3% were women. The prevalence of high CMD symptoms (six or more symptoms on the SRQ-20 was 24.5%. Suicidal ideation was reported by 13.8% of the participants. CMD symptoms were significantly higher in patients who had taken medication prior to visiting the primary care (p = 0.012 and in those whose symptoms had been present for seven days or more (p = 0.041. There was no statistically significant association between level of CMD symptoms and having a negative thick film result (OR 0.98; 95%CI 0.92, 1.04 or objective presence of fever (OR 1.04; 95%CI 0.93, 1.15.CMD symptoms among cases of malaria did not appear to be associated with a negative thick film result. The high levels of CMD symptoms, including suicidal ideation, calls for further studies to investigate the persistence and progression of these symptoms following resolution of the acute malarial episode.

  1. Initial Report of a Prospective Dosimetric and Clinical Feasibility Trial Demonstrates the Potential of Protons to Increase the Therapeutic Ratio in Breast Cancer Compared With Photons

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, Julie A., E-mail: jbradley@floridaproton.org; Dagan, Roi; Ho, Meng Wei; Rutenberg, Michael; Morris, Christopher G.; Li, Zuofeng; Mendenhall, Nancy P.

    2016-05-01

    Purpose: To compare dosimetric endpoints between proton therapy (PT) and conventional radiation and determine the feasibility of PT for regional nodal irradiation (RNI) in women with breast cancer. Methods and Materials: From 2012 to 2014, 18 women (stage IIA-IIIB) requiring RNI prospectively enrolled on a pilot study. Median age was 51.8 years (range, 42-73 years). The cohort included breast-conserving therapy (BCT) and mastectomy patients and right- and left-sided cancers. Treatment targets and organs at risk were delineated on computed tomography scans, and PT and conventional plans were developed. Toxicity was prospectively recorded using Common Terminology Criteria for Adverse Events version 4.0. A Wilcoxon signed-rank sum test compared the dose-volume parameters. The primary endpoint was a reduction in cardiac V5. Results: Median follow-up was 20 months (range, 2-31 months). For all patients, the PT plan better met the dosimetric goals and was used for treatment. Proton therapy alone was used for 10 patients (9 postmastectomy, 1 after BCT) and combined proton–photon in 8 (6 BCT, 2 postmastectomy with immediate expander reconstruction). Proton therapy improved coverage of level 2 axilla (P=.0005). Adequate coverage of internal mammary nodes was consistently achieved with PT (median D95, 50.3 Gy; range, 46.6-52.1 Gy) but not with conventional radiation therapy (median D95, 48.2 Gy; range, 40.8-55 Gy; P=.0005). Median cardiac V5 was 0.6% with PT and 16.3% with conventional radiation (P<.0001). Median ipsilateral lung V5 and V20 were improved with PT (median V5 35.3% vs 60.5% [P<.0001]; and median V20, 21.6% vs 35.5% [P<.0001]). Grade 3 dermatitis developed in 4 patients (22%), which was the only grade 3 toxicity. No grade 4+ toxicities developed. Conclusion: Proton therapy for RNI after mastectomy or BCT significantly improves cardiac dose, especially for left-sided patients, and lung V5 and V20 in all patients without excessive acute toxicity

  2. Trends and implications for achieving VISION 2020 human resources for eye health targets in 16 countries of sub-Saharan Africa by the year 2020.

    Science.gov (United States)

    Palmer, Jennifer J; Chinanayi, Farai; Gilbert, Alice; Pillay, Devan; Fox, Samantha; Jaggernath, Jyoti; Naidoo, Kovin; Graham, Ronnie; Patel, Daksha; Blanchet, Karl

    2014-08-15

    Development of human resources for eye health (HReH) is a major global eye health strategy to reduce the prevalence of avoidable visual impairment by the year 2020. Building on our previous analysis of current progress towards key HReH indicators and cataract surgery rates (CSRs), we predicted future indicator achievement among 16 countries of sub-Saharan Africa by 2020. Surgical and HReH data were collected from national eye care programme coordinators on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and 'mid-level refractionists' and combined them with publicly available population data to calculate practitioner-to-population ratios and CSRs. Data on workforce entry and exit (2008 to 2010) was used to project practitioner population and CSR growth between 2011 and 2020 in relation to projected growth in the general population. Associations between indicator progress and the presence of a non-physician cataract surgeon cadre were also explored using Wilcoxon rank sum tests and Spearman rank correlations. In our 16-country sample, practitioner per million population ratios are predicted to increase slightly for surgeons (ophthalmologists/cataract surgeons, from 3.1 in 2011 to 3.4 in 2020) and ophthalmic nurses/clinical officers (5.8 to 6.8) but remain low for refractionists (including optometrists, at 3.6 in 2011 and 2020). Among countries that have not already achieved target indicators, however, practitioner growth will be insufficient for any additional countries to reach the surgeon and refractionist targets by year 2020. Without further strategy change and investment, even after 2020, surgeon growth is only expected to sufficiently outpace general population growth to reach the target in one country. For nurses, two additional countries will achieve the target while one will fall below it. In 2011, high surgeon practitioner ratios were associated with high CSR, regardless of the type

  3. Climate change projections for winter precipitation over Tropical America using statistical downscaling

    Science.gov (United States)

    Palomino-Lemus, Reiner; Córdoba-Machado, Samir; Quishpe-Vásquez, César; García-Valdecasas-Ojeda, Matilde; Raquel Gámiz-Fortis, Sonia; Castro-Díez, Yolanda; Jesús Esteban-Parra, María

    2017-04-01

    In this study the Principal Component Regression (PCR) method has been used as statistical downscaling technique for simulating boreal winter precipitation in Tropical America during the period 1950-2010, and then for generating climate change projections for 2071-2100 period. The study uses the Global Precipitation Climatology Centre (GPCC, version 6) data set over the Tropical America region [30°N-30°S, 120°W-30°W] as predictand variable in the downscaling model. The mean monthly sea level pressure (SLP) from the National Center for Environmental Prediction - National Center for Atmospheric Research (NCEP-NCAR reanalysis project), has been used as predictor variable, covering a more extended area [30°N-30°S, 180°W-30°W]. Also, the SLP outputs from 20 GCMs, taken from the Coupled Model Intercomparison Project (CMIP5) have been used. The model data include simulations with historical atmospheric concentrations and future projections for the representative concentration pathways RCP2.6, RCP4.5, and RCP8.5. The ability of the different GCMs to simulate the winter precipitation in the study area for present climate (1971-2000) was analyzed by calculating the differences between the simulated and observed precipitation values. Additionally, the statistical significance at 95% confidence level of these differences has been estimated by means of the bilateral rank sum test of Wilcoxon-Mann-Whitney. Finally, to project winter precipitation in the area for the period 2071-2100, the downscaling model, recalibrated for the total period 1950-2010, was applied to the SLP outputs of the GCMs under the RCP2.6, RCP4.5, and RCP8.5 scenarios. The results show that, generally, for present climate the statistical downscaling shows a high ability to faithfully reproduce the precipitation field, while the simulations performed directly by using not downscaled outputs of GCMs strongly distort the precipitation field. For future climate, the projected predictions under the RCP4

  4. Light curing through glass ceramics: effect of curing mode on micromechanical properties of dual-curing resin cements.

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    Flury, Simon; Lussi, Adrian; Hickel, Reinhard; Ilie, Nicoleta

    2014-04-01

    The aim of this study was to investigate micromechanical properties of five dual-curing resin cements after different curing modes including light curing through glass ceramic materials. Vickers hardness (VH) and indentation modulus (Y HU) of Panavia F2.0, RelyX Unicem 2 Automix, SpeedCEM, BisCem, and BeautiCem SA were measured after 1 week of storage (37 °C, 100 % humidity). The resin cements were tested following self-curing or light curing with the second-generation light-emitting diode (LED) curing unit Elipar FreeLight 2 in Standard Mode (1,545 mW/cm(2)) or with the third-generation LED curing unit VALO in High Power Mode (1,869 mW/cm(2)) or in XtraPower Mode (3,505 mW/cm(2)). Light curing was performed directly or through glass ceramic discs of 1.5 or 3 mm thickness of IPS Empress CAD or IPS e.max CAD. VH and Y HU were analysed with Kruskal-Wallis tests followed by pairwise Wilcoxon rank sum tests (α = 0.05). RelyX Unicem 2 Automix resulted in the highest VH and Y HU followed by BeautiCem SA, BisCem, SpeedCEM, and finally Panavia F2.0. Self-curing of RelyX Unicem 2 Automix and SpeedCEM lowered VH and Y HU compared to light curing whereas self-curing of Panavia F2.0, BisCem, and BeautiCem SA led to similar or significantly higher VH and Y HU compared to light curing. Generally, direct light curing resulted in similar or lower VH and Y HU compared to light curing through 1.5-mm-thick ceramic discs. Light curing through 3-mm-thick discs of IPS e.max CAD generally reduced VH and Y HU for all resin cements except SpeedCEM, which was the least affected by light curing through ceramic discs. The resin cements responded heterogeneously to changes in curing mode. The applied irradiances and light curing times adequately cured the resin cements even through 1.5-mm-thick ceramic discs. When light curing resin cements through thick glass ceramic restorations, clinicians should consider to prolong the light curing times even with LED curing units providing high

  5. Identification of common features of vehicle motion under drowsy/distracted driving: A case study in Wuhan, China.

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    Chen, Zhijun; Wu, Chaozhong; Zhong, Ming; Lyu, Nengchao; Huang, Zhen

    2015-08-01

    Drowsy/distracted driving has become one of the leading causes of traffic crash. Only certain particular drowsy/distracted driving behaviors have been studied by previous studies, which are mainly based on dedicated sensor devices such as bio and visual sensors. The objective of this study is to extract the common features for identifying drowsy/distracted driving through a set of common vehicle motion parameters. An intelligent vehicle was used to collect vehicle motion parameters. Fifty licensed drivers (37 males and 13 females, M=32.5 years, SD=6.2) were recruited to carry out road experiments in Wuhan, China and collecting vehicle motion data under four driving scenarios including talking, watching roadside, drinking and under the influence of drowsiness. For the first scenario, the drivers were exposed to a set of questions and asked to repeat a few sentences that had been proved valid in inducing driving distraction. Watching roadside, drinking and driving under drowsiness were assessed by an observer and self-reporting from the drivers. The common features of vehicle motions under four types of drowsy/distracted driving were analyzed using descriptive statistics and then Wilcoxon rank sum test. The results indicated that there was a significant difference of lateral acceleration rates and yaw rate acceleration between "normal driving" and drowsy/distracted driving. Study results also shown that, under drowsy/distracted driving, the lateral acceleration rates and yaw rate acceleration were significantly larger from the normal driving. The lateral acceleration rates were shown to suddenly increase or decrease by more than 2.0m/s(3) and the yaw rate acceleration by more than 2.5°/s(2). The standard deviation of acceleration rate (SDA) and standard deviation of yaw rate acceleration (SDY) were identified to as the common features of vehicle motion for distinguishing the drowsy/distracted driving from the normal driving. In order to identify a time window for

  6. Emphysema quantification and lung volumetry in chest X-ray equivalent ultralow dose CT - Intra-individual comparison with standard dose CT.

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    Messerli, Michael; Ottilinger, Thorsten; Warschkow, René; Leschka, Sebastian; Alkadhi, Hatem; Wildermuth, Simon; Bauer, Ralf W

    2017-06-01

    To determine whether ultralow dose chest CT with tin filtration can be used for emphysema quantification and lung volumetry and to assess differences in emphysema measurements and lung volume between standard dose and ultralow dose CT scans using advanced modeled iterative reconstruction (ADMIRE). 84 consecutive patients from a prospective, IRB-approved single-center study were included and underwent clinically indicated standard dose chest CT (1.7±0.6mSv) and additional single-energy ultralow dose CT (0.14±0.01mSv) at 100kV and fixed tube current at 70mAs with tin filtration in the same session. Forty of the 84 patients (48%) had no emphysema, 44 (52%) had emphysema. One radiologist performed fully automated software-based pulmonary emphysema quantification and lung volumetry of standard and ultralow dose CT with different levels of ADMIRE. Friedman test and Wilcoxon rank sum test were used for multiple comparison of emphysema and lung volume. Lung volumes were compared using the concordance correlation coefficient. The median low-attenuation areas (LAA) using filtered back projection (FBP) in standard dose was 4.4% and decreased to 2.6%, 2.1% and 1.8% using ADMIRE 3, 4, and 5, respectively. The median values of LAA in ultralow dose CT were 5.7%, 4.1% and 2.4% for ADMIRE 3, 4, and 5, respectively. There was no statistically significant difference between LAA in standard dose CT using FBP and ultralow dose using ADMIRE 4 (p=0.358) as well as in standard dose CT using ADMIRE 3 and ultralow dose using ADMIRE 5 (p=0.966). In comparison with standard dose FBP the concordance correlation coefficients of lung volumetry were 1.000, 0.999, and 0.999 for ADMIRE 3, 4, and 5 in standard dose, and 0.972 for ADMIRE 3, 4 and 5 in ultralow dose CT. Ultralow dose CT at chest X-ray equivalent dose levels allows for lung volumetry as well as detection and quantification of emphysema. However, longitudinal emphysema analyses should be performed with the same scan protocol and

  7. Changes in social interaction over 20 years and the effects of community resources use among community-dwelling elderly persons.

    Science.gov (United States)

    Watanabe, Kumi; Tanaka, Emiko; Wu, Bailiang; Kobayashi, Zyunko; Mochizuki, Yukiko; Kim, Yeon; Watanabe, Taeko; Okumura, Rika; Ito, Sumio; Anme, Tokie

    2017-01-01

    Objectives Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.Methods The participants were community-dwelling elderly persons aged 65 years and over. A survey was conducted 8 times from 1994 to 2014 in the suburban area of Tobishima, Japan. The Index of Social Interaction Scale was used and each subscale and the total score were calculated. Subsequently, the 2014 scores were compared with the 1994 scores using the Wilcoxon rank sum test. Logistic regression analysis was conducted to clarify the factors related to social interaction, focusing on the association between the use of community resources (local elderly management center, health care center, health promotion facility, library) in 2011 and social interaction 3 years later. Age, gender, disease, and mobility were also entered into the model as control variables.Results Comparing social interaction in 1994 and 2014, total scores were found to have significantly increased in all age groups. Independence scores significantly increased in the overall group and in females aged 75-84. Curiosity scores also increased in both males and females. These results show that social interaction has increased over 2 decades. In addition, the use of local elderly management and health care centers, and health promotion facilities was associated with total social interaction scores 3 years later.Conclusion The current study clarified changes in social interaction, both comprehensively and for each of its aspects, among community-dwelling elderly adults. Increasing social isolation has been reported in recent years; however, the current study showed that social

  8. Feasibility of alanine aminotransferase/aspartate aminotransferase ratio in predicting hepatic steatosis in chronic hepatitis C patients

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    ZHANG Xiuli

    2017-06-01

    Full Text Available ObjectiveTo investigate the feasibility of alanine aminotransferase (ALT/aspartate aminotransferase (AST ratio in predicting the degree of hepatic steatosis in chronic hepatitis C (CHC patients. MethodsA total of 231 CHC patients who visited The First People′s Hospital of Nanyang from May 2012 to June 2016 were enrolled, among whom 105 (45.45% had nonalcoholic fatty liver disease (NAFLD and 126 (54.55% did not have NAFLD. According to the ultrasound score, the NAFLD group was divided into mild-to-moderate (1-2 points hepatic steatosis group(n=67 and severe (3 points hepatic steatosis group(n=38. The two groups were compared in terms of demographic data and disease data including creatinine, fasting blood glucose, ALT, AST, ALT/AST ratio, γ-glutamyltransferase (GGT, uric acid, low-density lipoprotein, high-density lipoprotein (HDL, cholesterol (CHO, and triglyceride (TG to screen out independent risk factors for NAFLD in CHC patients. The independent samples t-test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups; with severe NAFLD as the dependent variable, different factors were introduced into the logistic regression equation to screen out independent risk factors. ResultsCompared with the non-NAFLD group, the NAFLD group had significantly higher systolic pressure, diastolic pressure, fasting blood glucose, ALT/AST ratio, and levels of ALT, GGT, HDL, CHO, and TG, as well as a significantly higher proportion of patients with diabetes, hypertension, or metabolic syndrome (all P<0.05. Compared with the severe hepatic steatosis group, the mild-to-moderate hepatic steatosis group had significantly lower systolic pressure, diastolic pressure, fasting blood glucose, ALT/AST ratio, and levels of ALT, GGT, HDL, CHO, and TG, as

  9. Niacin extended-release/simvastatin combination therapy produces larger favorable changes in high-density lipoprotein particles than atorvastatin monotherapy

    Directory of Open Access Journals (Sweden)

    Toth PP

    2012-01-01

    Full Text Available Peter P Toth1, Kamlesh M Thakker2, Ping Jiang2, Robert J Padley21University of Illinois College of Medicine, Peoria, and CGH Medical Center, Sterling, 2Abbott, Abbott Park, IL, USABackground: The purpose of this research was to compare the effects of niacin extended-release in combination with simvastatin (NER/S versus atorvastatin monotherapy on high-density lipoprotein (HDL particle number and size in patients with hyperlipidemia or dyslipidemia from the SUPREME study.Methods: This was a post hoc analysis of patients (n = 137 who completed the SUPREME study and who had lipid particle number and size measurements at both baseline and at week 12 by nuclear magnetic resonance spectroscopy. Following ≥4 weeks without lipid-modifying therapy (washout period, the patients received NER/S 1000/40 mg/day for 4 weeks followed by NER/S 2000/40 mg/day for 8 weeks, or atorvastatin 40 mg/day for 12 weeks. Median percent changes in HDL particle number and size from baseline to week 12 were compared between the NER/S and atorvastatin treatment groups using the Wilcoxon rank-sum test. Distribution of HDL particle subclasses at week 12 was compared between the treatment groups using the Cochran–Mantel–Haenszel test.Results: Treatment with NER/S resulted in a significantly greater percent reduction in small HDL particle number at week 12 compared with atorvastatin monotherapy (-1.8% versus 4.2%, P = 0.014, and a numerically greater percent increase in large HDL particle number (102.4% versus 39.2%, P = 0.078 compared with atorvastatin monotherapy. A significantly greater percent increase in HDL particle size from baseline at week 12 was observed with NER/S compared with atorvastatin (6.0% versus 1.3%, P < 0.001. NER/S treatment also resulted in a significant shift in HDL particle size from small and medium at baseline to large at week 12 (P < 0.0001.Conclusion: Treatment with NER/S resulted in larger favorable changes in number and size of HDL particle

  10. A Cross-Sectional Study Evaluating the Impact of One Year versus Two Years of Exposure to Interprofessional Education on Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education (SPICE

    Directory of Open Access Journals (Sweden)

    Melissa E Rotz

    2016-10-01

    Full Text Available Background: Evaluating student perceptions of interprofessional education (IPE is important to meet accreditation standards. The objective of this study was to evaluate the impact of one year versus two years of exposure to IPE on student perceptions, as well as evaluate differences between professions. Methods: In this cross-sectional study, first and second year medical and pharmacy students enrolled in an interprofessional experiential course series at each of their respective institutions completed a perceptions instrument prior to a standardized objective behavioral assessment. Student demographics and perception scores were summarized using descriptive statistics. Chi-squared tests and Cochran-Mantel-Haenszel tests were used to assess differences in demographic variables. Between-group differences in perception scores were assessed using Wilcoxon Rank-Sum tests. Results: 155 students completed the instrument out of the 163 students enrolled in the course series. Overall, the median scores were ≥4 (4=Agree, 5=Strongly Agree for all SPICE items and factors. No significant differences were observed between first and second year students in response to any of the SPICE items or factors. When comparing professions, significant differences were observed between pharmacy students and medical students that IPE “enhances my education” (p=0.003, “improves patient satisfaction” (p=0.001, and “enhances my future ability to collaborate” (p=0.001. Significant differences were also observed between pharmacy students and medical students for 2 of the 3 factors: teamwork (p=0.001 and patient outcomes (p=0.005. For all of the differences in items and factors, pharmacy students reported higher levels of agreement. Conclusions: Two years of exposure to IPE compared to one year (i.e. second year students vs. first year students did not result in higher levels of agreement; however, agreement was high across all students which may have limited the

  11. By Default: The Effect of Prepopulated Prescription Quantities on Opioid Prescribing in the Emergency Department.

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    Santistevan, Jamie R; Sharp, Brian R; Hamedani, Azita G; Fruhan, Scott; Lee, Andrew W; Patterson, Brian W

    2018-03-01

    Opioid prescribing patterns have come under increasing scrutiny with the recent rise in opioid prescriptions, opioid misuse and abuse, and opioid-related adverse events. To date, there have been limited studies on the effect of default tablet quantities as part of emergency department (ED) electronic order entry. Our goal was to evaluate opioid prescribing patterns before and after the removal of a default quantity of 20 tablets from ED electronic order entry. We performed a retrospective observational study at a single academic, urban ED with 58,000 annual visits. We identified all adult patients (18 years or older) seen in the ED and discharged home with prescriptions for tablet forms of hydrocodone and oxycodone (including mixed formulations with acetaminophen). We compared the quantity of tablets prescribed per opioid prescription 12 months before and 10 months after the electronic order-entry prescription default quantity of 20 tablets was removed and replaced with no default quantity. No specific messaging was given to providers, to avoid influencing prescribing patterns. We used two-sample Wilcoxon rank-sum test, two-sample test of proportions, and Pearson's chi-squared tests where appropriate for statistical analysis. A total of 4,104 adult patients received discharge prescriptions for opioids in the pre-intervention period (151.6 prescriptions per 1,000 discharged adult patients), and 2,464 post-intervention (106.69 prescriptions per 1,000 discharged adult patients). The median quantity of opioid tablets prescribed decreased from 20 (interquartile ration [IQR] 10-20) to 15 (IQR 10-20) (pdefault quantity. While the most frequent quantity of tablets received in both groups was 20 tablets, the proportion of patients who received prescriptions on discharge that contained 20 tablets decreased from 0.5 (95% confidence interval [CI] [0.48-0.52]) to 0.23 (95% CI [0.21-0.24]) (pdefault quantity removal. Although the median number of tablets differed significantly

  12. PI-RADS version 2 for prediction of pathological downgrading after radical prostatectomy: a preliminary study in patients with biopsy-proven Gleason Score 7 (3+4) prostate cancer.

    Science.gov (United States)

    Woo, Sungmin; Kim, Sang Youn; Lee, Joongyub; Kim, Seung Hyup; Cho, Jeong Yeon

    2016-10-01

    To evaluate PI-RADSv2 for predicting pathological downgrading after radical prostatectomy (RP) in patients with biopsy-proven Gleason score (GS) 7(3+4) PC. A total of 105 patients with biopsy-proven GS 7(3+4) PC who underwent multiparametric prostate MRI followed by RP were included. Two radiologists assigned PI-RADSv2 scores for each patient. Preoperative clinicopathological variables and PI-RADSv2 scores were compared between patients with and without downgrading after RP using the Wilcoxon rank sum test or Fisher's exact test. Logistic regression analyses with Firth's bias correction were performed to assess their association with downgrading. Pathological downgrading was identified in ten (9.5 %) patients. Prostate-specific antigen (PSA), PSA density, percentage of cores with GS 7(3+4), and greatest percentage of core length (GPCL) with GS 7(3+4) were significantly lower in patients with downgrading (p = 0.002-0.037). There was no significant difference in age and clinical stage (p = 0.537-0.755). PI-RADSv2 scores were significantly lower in patients with downgrading (3.8 versus 4.4, p = 0.012). At univariate logistic regression analysis, PSA, PSA density, and PI-RADSv2 scores were significant predictors of downgrading (p = 0.003-0.022). Multivariate analysis revealed only PSA density and PI-RADSv2 scores as independent predictors of downgrading (p = 0.014-0.042). The PI-RADSv2 scoring system was an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4) PC. • PI-RADSv2 was an independent predictor of downgrading in biopsy-proven GS 7(3+4) PC • PSA density was also an independent predictor of downgrading • MRI may assist in identifying AS candidates in biopsy-proven GS 7(3+4) PC patients.

  13. Prognostic Factors of Organophosphate Poisoning Between the Death and Survival Groups

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    Tzeng-Jih Lin

    2007-04-01

    Full Text Available In this prospective case series study, we consider the different factors between death and survival groups of organophosphate poisoning. Patients in tertiary-care medical center who had been exposed to organophosphate were included in the study. Pralidoxime (PAM was discontinued after atropine had controlled the clinical situation. We recorded the demographic data, amount of organophosphate consumption, duration of coma, duration of ventilator use, duration of hospitalization, findings of chest X-ray, white blood cell count, acetylcholinesterase concentration, plasma cholinesterase concentration, total atropine amount, duration of atropine use, total PAM amount, duration of PAM use, urine organophosphate peak concentration, duration of urine organophosphate and mortality rate. Urine was collected every 8 hours and was analyzed by gas chromatography equipped with a flame photometric detector and gas chromatography with mass spectrometer detector for organophosphate determination. The urine organophosphate peak concentration was recorded. Wilcoxon rank sum test was used to compare the factors between death and survival groups. Fisher's exact test was used to compare the different findings of chest X-ray between the death and survival groups. Evidently, the death group had a higher amount of organophosphate consumption, duration of coma, and higher white blood cell count than those in the survival group. Also, the death group had lower duration of hospitalization, and decreased concentrations of acetylcholinesterase and plasma cholinesterase. Total PAM amount use and duration of PAM use were lower. However, the duration of ventilator use, findings of chest X-ray, total atropine amount, duration of atropine, urine organophosphate peak concentration and duration of urine organophosphate were similar in both groups. The mortality rate of our 50 cases was 20%. As stated earlier, the cases of the death group had insufficient PAM therapy. The maximum

  14. Increased Heat Generation in Postcardiac Arrest Patients During Targeted Temperature Management Is Associated With Better Outcomes.

    Science.gov (United States)

    Uber, Amy J; Perman, Sarah M; Cocchi, Michael N; Patel, Parth V; Ganley, Sarah E; Portmann, Jocelyn M; Donnino, Michael W; Grossestreuer, Anne V

    2018-04-03

    Assess if amount of heat generated by postcardiac arrest patients to reach target temperature (Ttarget) during targeted temperature management is associated with outcomes by serving as a proxy for thermoregulatory ability, and whether it modifies the relationship between time to Ttarget and outcomes. Retrospective cohort study. Urban tertiary-care hospital. Successfully resuscitated targeted temperature management-treated adult postarrest patients between 2008 and 2015 with serial temperature data and Ttarget less than or equal to 34°C. None. Time to Ttarget was defined as time from targeted temperature management initiation to first recorded patient temperature less than or equal to 34°C. Patient heat generation ("heat units") was calculated as inverse of average water temperature × hours between initiation and Ttarget × 100. Primary outcome was neurologic status measured by Cerebral Performance Category score; secondary outcome was survival, both at hospital discharge. Univariate analyses were performed using Wilcoxon rank-sum tests; multivariate analyses used logistic regression. Of 203 patients included, those with Cerebral Performance Category score 3-5 generated less heat before reaching Ttarget (median, 8.1 heat units [interquartile range, 3.6-21.6 heat units] vs median, 20.0 heat units [interquartile range, 9.0-33.5 heat units]; p = 0.001) and reached Ttarget quicker (median, 2.3 hr [interquartile range, 1.5-4.0 hr] vs median, 3.6 hr [interquartile range, 2.0-5.0 hr]; p = 0.01) than patients with Cerebral Performance Category score 1-2. Nonsurvivors generated less heat than survivors (median, 8.1 heat units [interquartile range, 3.6-20.8 heat units] vs median, 19.0 heat units [interquartile range, 6.5-33.5 heat units]; p = 0.001) and reached Ttarget quicker (median, 2.2 hr [interquartile range, 1.5-3.8 hr] vs median, 3.6 hr [interquartile range, 2.0-5.0 hr]; p = 0.01). Controlling for average water temperature between initiation and Ttarget, the

  15. [Changes in nutritional status of patients with different diseases during hospitalization].

    Science.gov (United States)

    Cui, H Y; Zhu, M W; Wei, J M; Chen, W; Yang, X; Zhu, S N

    2017-04-01

    Objective: To evaluate changes in nutritional status of hospitalized patients with different diseases by subjective global assessment (SGA) and nutritional risk screening (NRS-2002). Methods: A prospective and parallel research done by multi-center collaboration from 34 hospitals in China from June to September 2014. Hospitalized patients with the following diseases were investigated: malignant tumor (2 487 cases), benign disease of the digestive system (1 358 cases), benign disease of the nervous system (1 043 cases), benign bone disease (451 cases), benign disease of the respiratory system(395 cases), cardiovascular disease (227 cases), benign thyroid and breast disease (179 cases), and endocrine disease (149 cases). Patients above the age of 18 and hospitalization time between 7-30 days were included. Physical indexes were measured, the NRS-2002 and SGA scores were recorded, the nutritional support were recorded during hospitalization and 24 hours after discharge from hospital. Measurement data between groups were analyzed using t test or Wilcoxon rank sum test, enumeration data and ranked data between groups were analyzed using chi-square test or Fisher exact test. Results: There were 6 638 cases of hospitalized patients, 3 861 cases were males and 2 777 were females, the male/female ratio was 1.4∶1.0; the median age was 60 years; the median height was 1.66 m; the median weight was 62 kg; the median body mass index (BMI)was 22.89 kg/m(2). At discharge, compared with that of admission, the body weight, BMI, grip strength, upper arm and calf circumferences of patients with malignant tumor were significantly decreased ( t =20.15-259.67, all P nutritional risk incidence rate (from NRS-2002) of patients with malignant tumor was significantly higher(χ(2)=21.275, P =0.000); moderate malnutrition (from SGA) incidence rate was significantly higher(χ(2)=62.318, P =0.000; χ(2)=11.312, P nutritional deficiency(except those with digestive benign diseases )received

  16. The effects of neutralized particles on the sampling efficiency of polyurethane foam used to estimate the extrathoracic deposition fraction.

    Science.gov (United States)

    Tomyn, Ronald L; Sleeth, Darrah K; Thiese, Matthew S; Larson, Rodney R

    2016-01-01

    In addition to chemical composition, the site of deposition of inhaled particles is important for determining the potential health effects from an exposure. As a result, the International Organization for Standardization adopted a particle deposition sampling convention. This includes extrathoracic particle deposition sampling conventions for the anterior nasal passages (ET1) and the posterior nasal and oral passages (ET2). This study assessed how well a polyurethane foam insert placed in an Institute of Occupational Medicine (IOM) sampler can match an extrathoracic deposition sampling convention, while accounting for possible static buildup in the test particles. In this way, the study aimed to assess whether neutralized particles affected the performance of this sampler for estimating extrathoracic particle deposition. A total of three different particle sizes (4.9, 9.5, and 12.8 µm) were used. For each trial, one particle size was introduced into a low-speed wind tunnel with a wind speed set a 0.2 m/s (∼40 ft/min). This wind speed was chosen to closely match the conditions of most indoor working environments. Each particle size was tested twice either neutralized, using a high voltage neutralizer, or left in its normal (non neutralized) state as standard particles. IOM samplers were fitted with a polyurethane foam insert and placed on a rotating mannequin inside the wind tunnel. Foam sampling efficiencies were calculated for all trials to compare against the normalized ET1 sampling deposition convention. The foam sampling efficiencies matched well to the ET1 deposition convention for the larger particle sizes, but had a general trend of underestimating for all three particle sizes. The results of a Wilcoxon Rank Sum Test also showed that only at 4.9 µm was there a statistically significant difference (p-value = 0.03) between the foam sampling efficiency using the standard particles and the neutralized particles. This is interpreted to mean that static

  17. Health outcomes in diabetics measured with Minnesota Community Measurement quality metrics

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2014-12-01

    Full Text Available Paul Y Takahashi,1 Jennifer L St Sauver,2 Lila J Finney Rutten,2 Robert M Jacobson,3 Debra J Jacobson,2 Michaela E McGree,2 Jon O Ebbert1 1Department of Internal Medicine, Division of Primary Care Internal Medicine, 2Department of Health Sciences Research, Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery, 3Department of Pediatric and Adolescent Medicine, Division of Community Pediatrics, Mayo Clinic, Rochester, MN, USA Objective: Our objective was to understand the relationship between optimal diabetes control, as defined by Minnesota Community Measurement (MCM, and adverse health outcomes including emergency department (ED visits, hospitalizations, 30-day rehospitalization, intensive care unit (ICU stay, and mortality. Patients and methods: In 2009, we conducted a retrospective cohort study of empaneled Employee and Community Health patients with diabetes mellitus. We followed patients from 1 September 2009 until 30 June 2011 for hospitalization and until 5 January 2014 for mortality. Optimal control of diabetes mellitus was defined as achieving the following three measures: low-density lipoprotein (LDL cholesterol <100 mg/mL, blood pressure <140/90 mmHg, and hemoglobin A1c <8%. Using the electronic medical record, we assessed hospitalizations, ED visits, ICU stays, 30-day rehospitalizations, and mortality. The chi-square or Wilcoxon rank-sum tests were used to compare those with and without optimal control. We used Cox proportional hazard models to estimate the associations between optimal diabetes mellitus status and each outcome. Results: We identified 5,731 empaneled patients with diabetes mellitus; 2,842 (49.6% were in the optimal control category. After adjustment, we observed that non-optimally controlled patients had higher risks for hospitalization (hazard ratio [HR] 1.11; 95% confidence interval [CI] 1.00–1.23, ED visits (HR 1.15; 95% CI 1.06–1.25, and mortality (HR 1.29; 95% CI 1.09–1

  18. Comparative assessment of quality of immunoradiometric assay (IRMA) and chemiluminescence immunometric assay (CHEIMA) for estimation of thyroid stimulating hormone (TSH)

    International Nuclear Information System (INIS)

    Sajid, K.M.

    2009-01-01

    Biological substances like hormones, vitamins and enzymes are found in minute quantities in blood. Their estimation requires very sensitive and specific methods. The most modern method for estimation of thyroid stimulating hormone in serum is non-isotopic enzyme enhanced chemiluminescence immunometric method. In our laboratory immunoradiometric assay is in routine for the last many years. Recently interest has grown to establish non-isotopic techniques in laboratories of PAEC. However, the main requirement to adopt the new procedures is to compare their results, cost and other benefits with the existing method. Immunoassay laboratory of MINAR, therefore, conducted a study to compare the two methods. A total of 173 (males: 34 females: 139 age: between 1 and 65 years) cases of clinically confirmed thyroid status were included in the study. Serum samples of these cases were analyzed by two methods and results were compared by plotting precision profiles, correlation plots and calculating sensitivities and specificities of the methods. As the results in all the samples were not normally distributed Wilcoxon rank sum test was applied to compare the analytical results of two methods. The comparison shows that the results obtained in two methods are not completely similar (p=0.0003293), although analysis of samples in groups shows that some similarity exists between the results of hypo and hyperthyroid patients (p<=0.156 and p<=0.6138). This shows that results obtained in these two methods could sometimes disagree in final diagnosis. Although TSH-CHEIMA is analytically more sensitive than TSH-IRMA the clinical sensitivities and specificities of two methods are not significantly different. TSH-CHEIMA test completes in almost 2 hours whereas TSH-IRMA takes about 6 hours to complete. Comparison of costs shows that TSH-CHIEMA is almost 5 times more expensive than TSH-IRMA. We conclude that the two methods could sometimes disagree but the two techniques have almost same

  19. A PET/MRI study towards finding the optimal [{sup 18}F]Fluciclovine PET protocol for detection and characterisation of primary prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Elschot, Mattijs; Sandsmark, Elise; Tessem, May-Britt [NTNU, Norwegian University of Science and Technology, Deparment of Circulation and Medical Imaging, Faculty of Medicine, Trondheim (Norway); Selnaes, Kirsten M.; Bathen, Tone F. [NTNU, Norwegian University of Science and Technology, Deparment of Circulation and Medical Imaging, Faculty of Medicine, Trondheim (Norway); Trondheim University Hospital, St. Olavs Hospital, Trondheim (Norway); Krueger-Stokke, Brage [NTNU, Norwegian University of Science and Technology, Deparment of Circulation and Medical Imaging, Faculty of Medicine, Trondheim (Norway); Trondheim University Hospital, Department of Radiology, St. Olavs Hospital, Trondheim (Norway); Stoerkersen, Oeystein [Trondheim University Hospital, Department of Pathology, St. Olavs Hospital, Trondheim (Norway); Moestue, Siver A. [NTNU, Norwegian University of Science and Technology, Deparment of Circulation and Medical Imaging, Faculty of Medicine, Trondheim (Norway); NTNU, Norwegian University of Science and Technology, Department of Laboratory Medicine, Children' s and Women' s Health, Faculty of Medicine, Trondheim (Norway); Bertilsson, Helena [Trondheim University Hospital, Department of Urology, St. Olavs Hospital, Trondheim (Norway); NTNU, Norwegian University of Science and Technology, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Trondheim (Norway)

    2017-04-15

    [{sup 18}F]Fluciclovine PET imaging shows promise for the assessment of prostate cancer. The purpose of this PET/MRI study is to optimise the PET imaging protocol for detection and characterisation of primary prostate cancer, by quantitative evaluation of the dynamic uptake of [{sup 18}F]Fluciclovine in cancerous and benign tissue. Patients diagnosed with high-risk primary prostate cancer underwent an integrated [{sup 18}F]Fluciclovine PET/MRI exam before robot-assisted radical prostatectomy with extended pelvic lymph node dissection. Volumes-of-interest (VOIs) of selected organs (prostate, bladder, blood pool) and sub-glandular prostate structures (tumour, benign prostatic hyperplasia (BPH), inflammation, healthy tissue) were delineated on T2-weighted MR images, using whole-mount histology samples as a reference. Three candidate windows for optimal PET imaging were identified based on the dynamic curves of the mean and maximum standardised uptake value (SUV{sub mean} and SUV{sub max}, respectively). The statistical significance of differences in SUV between VOIs were analysed using Wilcoxon rank sum tests (p<0.05, adjusted for multiple testing). Twenty-eight (28) patients [median (range) age: 66 (55-72) years] were included. An early (W1: 5-10 minutes post-injection) and two late candidate windows (W2: 18-23; W3: 33-38 minutes post-injection) were selected. Late compared with early imaging was better able to distinguish between malignant and benign tissue [W3, SUV{sub mean}: tumour vs. BPH 2.5 vs. 2.0 (p<0.001), tumour vs. inflammation 2.5 vs. 1.7 (p<0.001), tumour vs. healthy tissue 2.5 vs. 2.0 (p<0.001); W1, SUV{sub mean}: tumour vs. BPH 3.1 vs. 3.1 (p=0.771), tumour vs inflammation 3.1 vs. 2.2 (p=0.021), tumour vs. healthy tissue 3.1 vs. 2.5 (p<0.001)] as well as between high-grade and low/intermediate-grade tumours (W3, SUV{sub mean}: 2.6 vs. 2.1 (p=0.040); W1, SUV{sub mean}: 3.1 vs. 2.8 (p=0.173)). These differences were relevant to the peripheral zone, but

  20. Efficacy and Safety of Dalbavancin for the Treatment of Acute Bacterial Skin and Skin Structure Infection (ABSSSI) in Patients with Diabetes Mellitus

    Science.gov (United States)

    Nowak, Michael; Rappo, Urania; Gonzalez, Pedro L; Chen, Jie; McGregor, Jennifer S; Bryowsky, Jason; Talan, David

    2017-01-01

    Abstract Background ABSSSIs are common in patients with diabetes and have an increased risk of complications. Dalbavancin is a long-acting lipoglycopeptide with potent activity against Gram-positive pathogens responsible for ABSSSI, including methicillin-resistant Staphylococcus aureus (MRSA), and has demonstrated activity in ABSSSI with single-dose administration. We assessed outcomes in patients with and without diabetes in a clinical trial evaluating the efficacy of dalbavancin for ABSSSI. Methods In a double-blind, phase 3 trial, adult patients with ABSSSI involving deeper soft tissue or requiring significant surgical intervention, defined as major abscess, cellulitis, and traumatic wound/surgical site infection were randomized 1:1 to dalbavancin as a single-dose (1500 mg) or as a two-dose regimen (1000 mg on Day 1 and 500 mg on Day 8). The primary endpoint was ≥20% reduction in erythema at 48–72 hours; clinical success on Days 14 and 28 was defined as improvement in lesion size and signs and symptoms. P-values were obtained using Fisher’s exact test for categorical variables and Wilcoxon rank-sum test for continuous variables. In a post-hoc subgroup analysis, outcomes were compared among the subgroups of participants with and without diabetes. Results There were 76/698 (10.9%) participants with diabetes and 622/698 (89.1%) participants without diabetes. Participants with diabetes were more likely to be older or obese, and had higher rates of cellulitis, while participants without diabetes had higher rates of abscess (Figure 1). At Days 14 and 28, clinical success was achieved in ≥84% of participants with diabetes, and investigator assessment of cure was achieved in ≥95% of participants with diabetes (Figure 2). Drug-related adverse events were observed in 7 (9.2%) patients with and 44 (7.1%) participants without diabetes. Conclusion Dalbavancin has similar rates of clinical response and success for the treatment of ABSSSI in patients with or

  1. Treatment failure and drug resistance in HIV-positive patients on tenofovir-based first-line antiretroviral therapy in western Kenya.

    Science.gov (United States)

    Brooks, Katherine; Diero, Lameck; DeLong, Allison; Balamane, Maya; Reitsma, Marissa; Kemboi, Emmanuel; Orido, Millicent; Emonyi, Wilfred; Coetzer, Mia; Hogan, Joseph; Kantor, Rami

    2016-01-01

    Tenofovir-based first-line antiretroviral therapy (ART) is recommended globally. To evaluate the impact of its incorporation into the World Health Organization (WHO) guidelines, we examined treatment failure and drug resistance among a cohort of patients on tenofovir-based first-line ART at the Academic Model Providing Access to Healthcare, a large HIV treatment programme in western Kenya. We determined viral load (VL), drug resistance and their correlates in patients on ≥six months of tenofovir-based first-line ART. Based on enrolled patients' characteristics, we described these measures in those with (prior ART group) and without (tenofovir-only group) prior non-tenofovir-based first-line ART using Wilcoxon rank sum and Fisher's exact tests. Among 333 participants (55% female; median age 41 years; median CD4 336 cells/µL), detectable (>40 copies/mL) VL was found in 18%, and VL>1000 copies/mL (WHO threshold) in 10%. Virologic failure at both thresholds was significantly higher in 217 participants in the tenofovir-only group compared with 116 in the prior ART group using both cut-offs (24% vs. 7% with VL>40 copies/mL; 15% vs. 1% with VL>1000 copies/mL). Failure in the tenofovir-only group was associated with lower CD4 values and advanced WHO stage. In 35 available genotypes from 51 participants in the tenofovir-only group with VL>40 copies/mL (69% subtype A), any resistance was found in 89% and dual-class resistance in 83%. Tenofovir signature mutation K65R occurred in 71% (17/24) of the patients infected with subtype A. Patients with K65R had significantly lower CD4 values, higher WHO stage and more resistance mutations. In this Kenyan cohort, tenofovir-based first-line ART resulted in good (90%) virologic suppression including high suppression (99%) after switch from non-tenofovir-based ART. Lower virologic suppression (85%) and high observed resistance levels (89%) in the tenofovir-only group impact future treatment options, support recommendations for

  2. Combined pre-treatment MRI and 18F-FDG PET/CT parameters as prognostic biomarkers in patients with cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Miccò, Maura, E-mail: miccom@mskcc.org [Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Vargas, Hebert Alberto; Burger, Irene A. [Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Kollmeier, Marisa A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 1006 (United States); Goldman, Debra A. [Department of Epidemiology-Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd Street, New York, NY 10065 (United States); Park, Kay J. [Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Abu-Rustum, Nadeem R. [Department of Surgery, Gynecologic Oncology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States); Hricak, Hedvig; Sala, Evis [Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (United States)

    2014-07-15

    Objective: To determine the associations of quantitative parameters derived from multiphase contrast-enhanced magnetic resonance imaging (CE-MRI), diffusion-weighted (DW) MRI and 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/computed tomography (PET/CT) with clinico-histopathological prognostic factors, disease-free survival (DFS) and overall survival (OS) in patients with cervical cancer. Methods and materials: Our institutional review board approved this retrospective study of 49 patients (median age, 45 years) with histopathologically proven IB-IVB International Federation of Gynecology and Obstetrics (FIGO) cervical cancer who underwent pre-treatment pelvic MRI and whole-body 18F-FDG PET/CT between February 2009 and May 2012. Maximum diameter ({sub max}TD), percentage enhancement (PE) and mean apparent diffusion coefficient (ADC{sub mean}) of the primary tumor were measured on MRI. Maximum standardized uptake value (SUV{sub max}), metabolic tumor volume (MTV), total lesion glycolysis (TLG) were measured on 18F-FDG PET/CT. Correlations between imaging metrics and clinico-histopathological parameters including revised 2009 FIGO stage, tumor histology, grade and lymph node (LN) metastasis at diagnosis were evaluated using the Wilcoxon rank sum test. Cox modeling was used to determine associations with DFS and OS. Results: Median follow-up was 17 months. 41 patients (83.6%) were alive. 8 patients (16.3%) died of disease. Progression/recurrence occurred in 17 patients (34.6%). Significant differences were observed in ADC{sub mean}, SUV{sub max}, MTV and TLG according to FIGO stage (p < 0.001–0.025). There were significant correlations between ADC{sub mean}, MTV, TLG and LN metastasis (p = 0.017–0.032). SUV{sub max} was not associated with LN metastasis. FIGO stage (p = 0.017/0.033), LN metastases (p = 0.001/0.020), ADC{sub mean} (p = 0.007/0.020) and MTV (p = 0.014/0.026) were adverse predictors of both DFS/OS. {sub max}TD (p = 0.005) and TLG (p

  3. Pregnancy Outcomes in Women With a History of Previable, Preterm Prelabor Rupture of Membranes.

    Science.gov (United States)

    Monson, Martha A; Gibbins, Karen J; Esplin, M Sean; Varner, Michael W; Manuck, Tracy A

    2016-11-01

    To characterize subsequent pregnancy outcomes among women with a history of previable, preterm prelabor rupture of membranes (PROM) and assess factors associated with recurrent preterm birth. This was a retrospective cohort study of women cared for with a history of one or more singleton pregnancy complicated by preterm PROM at less than 24 weeks of gestation between 2002 and 2013 who were cared for in two tertiary care health systems by a single group of maternal-fetal medicine specialists. Women were identified using International Classification of Diseases, 9th Revision codes and obstetric databases. Those with iatrogenic preterm PROM and those whose index preterm PROM at less than 24 weeks of gestation was preceded by advanced cervical dilation were excluded. All women with one or more pregnancies reaching the second trimester after an index previable, preterm PROM pregnancy were included. The primary outcome was recurrent preterm birth at less than 37 weeks of gestation. Data were analyzed by χ, Fisher exact, t test, Wilcoxon rank-sum, and logistic regression. Two hundred ninety-four women had one or more pregnancies complicated by previable, preterm PROM. One hundred eight of 294 (37%) had one or more subsequent pregnancies in our health care systems and 50 of 108 (46%) had two or more. In the pregnancy immediately after the index delivery, the risk of prematurity was high: 50 (46%) delivered at less than 37 weeks of gestation, 31 (30%) at less than 34 weeks of gestation, 25 (23%) at less than 28 weeks of gestation, and 18 (17%) before 24 weeks of gestation. Fewer than half (n=49 [45%]) of women received preterm birth prophylaxis (progesterone or cerclage) in a subsequent pregnancy; rates of recurrent preterm birth were similar among women who received preterm birth prophylaxis compared with those who did not. In regression models, the only factor significantly associated with recurrent preterm birth at less than 37 weeks of gestation was a history of

  4. Analysis of the Revision Process by American Journal of Roentgenology Reviewers and Section Editors: Metrics of Rejected Manuscripts and Their Final Disposition.

    Science.gov (United States)

    Cejas, Claudia

    2017-06-01

    The objective of this study was to evaluate metrics related to manuscripts rejected by AJR with and without review during 2014 and to determine their final disposition: no record of eventual publication, eventually published, published with modified authors and title, published with the same title but modified authors, and published with modified title but the same authors. A total of 1245 unsolicited manuscripts submitted from January to December 2014 were included in this retrospective analysis. Data were extracted from the AJR's manuscript submission system. Standard statistical analysis was used to assess the fate of a sample of 200 rejected manuscripts. Of the 200 manuscripts studied, 117 (59%) were published in other scientific journals (61 with revision, 56 without revision; Χ 2 = 0.329, p = 0.566). Thirty-two of the 61 manuscripts (52%) rejected after peer review were later published in other journals without changes in their titles or authors, 16 (26%) with changes only in authors, 10 (16%) with changes only in their titles, and three (5%) with changes in authors and titles. Twenty-six of the 56 manuscripts (46%) rejected without peer review were published without changes in their titles or authors, 17 (30%) with changes in authors, 11 (20%) with changes only in their titles, and two (4%) with changes in both authors and titles (p = 0.686). Ten articles were published in open access journals. Of the remaining articles, those that had been reviewed were published in journals with a mean impact factor ± SD of 2.37 ± 1.30, and those that had not been reviewed were published in journals with a mean impact factor of 2.04 ± 1.06. Analysis of the 25th and 75th percentiles revealed that values were also higher for the group rejected with review (Wilcoxon rank sum test: W = 1679, p = 0.1127). Out of 61 articles rejected for publication with review, 52.5% were published with changes to their abstracts, whereas the remaining 47.5% were unchanged. This analysis

  5. Treatment of chronic telogen effluvium with oral minoxidil: A retrospective study [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Eshini Perera

    2017-09-01

    Full Text Available Background: Chronic telogen effluvium (CTE may be primary or secondary to various causes, including drug reaction, nutritional deficiency and female pattern hair loss (FPHL.  Oral minoxidil stimulates hair growth, and topical minoxidil is used in the treatment of FPHL and male androgenetic alopecia. minoxidil has not been used to treat CTE. This study aimed to assess the treatment of CTE with once daily oral minoxidil. Methods: Women with a diagnosis of CTE based on >6 month history of increased telogen hair shedding, no visible mid frontal scalp hair loss (Sinclair stage 1 and no hair follicle miniaturization on scalp biopsy were treated with once daily oral minoxidil.  Hair shedding scores (HSS at baseline, 6 and 12 months were analysed using the Wilcoxon rank sum test for pair-wise comparisons. Results: Thirty-six women were treated with oral minoxidil (range, 0.25-2.5 mg daily for 6 months.  Mean age was 46.9 years (range 20-83, HSS at baseline was 5.64, and duration of diagnosis was 6.55 years (range 1-27.  There was a reduction in mean HSS scores from baseline to 6 months of 1.7 (p<0.001 and baseline to 12 months of 2.58 (p<0.001. Five women who described trichodynia at baseline, noted improvement or resolution within 3 months.  Mean change in blood pressure was minus 0.5 mmHg systolic and plus 2.1 mmHg diastolic.  Two patients developed transient postural dizziness that resolved with continued treatment.  One patient developed ankle oedema.  Thirteen women developed facial hypertrichosis.  For 6 patients this was mild and did not require treatment; 4 had waxing of their upper lip or forehead; 3 had laser hair removal.  No patients developed any haematological abnormality.  All 36 women completed 12 months of treatment. Conclusions: Once daily oral minoxidil appears to reduce hair shedding in CTE.  Placebo controlled studies are recommended to further assess this response.

  6. Reduction of in utero lead exposures in South African populations: Positive impact of unleaded petrol.

    Directory of Open Access Journals (Sweden)

    Halina B Röllin

    Full Text Available Prenatal exposure to lead (Pb has been shown to have negative and irreversible health impacts on foetal and early childhood development, affecting morbidity and mortality in adulthood. This study aimed to assess in utero Pb exposure, examine birth outcomes, and identify confounding factors in the large cohort of South African population, following the legislated removal of Pb from petrol.Lead was measured in the maternal blood, urine and cord blood using Inductive Coupled Plasma Mass spectrometry (ICP-MS. The statistical analyses included Spearman's correlation, Wilcoxon rank sum (Mann Whitney, Kruskal-Wallis rank tests and multivariate linear regression.Overall, the geometric mean (GM of Pb in maternal blood (PbB was 1.32 μg/dL (n = 640; 95% CI, 1.24-1.40. In the subset cohort, the GM of paired maternal PbB and cord blood (PbC was 1.73 μg/dL (n = 350; 95% CI, 1.60-1.86 and 1.26 μg/dL (n = 317; 95% CI, 1.18-1.35, respectively with a positive correlation between the log PbB and the log PbC (rho = 0.65, p = <0.001. Birth outcomes showed geographical differences in the gestational age (p<0.001, birth length (p = 0.028 and head circumference (p<0.001, Apgar score at 5 min (p<0.001 and parity (p<0.002. In female neonates, a positive association was found between PbC and head circumference (rho = 0.243; p<0.016. The maternal PbB levels were positively correlated with race, educational status, water sources, cooking fuels and use of pesticides at home.This study has demonstrated not only the positive impact that the introduction of unleaded petrol and lead-free paint has had on in utero exposure to Pb in South Africa, but has also contributed new data on the topic, in a region where such data and scientific investigations in this field are lacking. Future research should evaluate if similar effects can be detected in young children and the adult population.

  7. 77 FR 6463 - Revisions to Labeling Requirements for Blood and Blood Components, Including Source Plasma...

    Science.gov (United States)

    2012-02-08

    ... Blood Components, Including Source Plasma; Correction AGENCY: Food and Drug Administration, HHS. ACTION..., Including Source Plasma,'' which provided incorrect publication information regarding a 60-day notice that...

  8. 76 FR 45878 - Alticor, Inc., Including Access Business Group International LLC and Amway Corporation, Buena...

    Science.gov (United States)

    2011-08-01

    ...,420B] Alticor, Inc., Including Access Business Group International LLC and Amway Corporation, Buena Park, CA; Alticor, Inc., Including Access Business Group International LLC and Amway Corporation...., Including Access Business Group International LLC and Amway Corporation, Including On-Site Leased Workers...

  9. Composite materials and bodies including silicon carbide and titanium diboride and methods of forming same

    Science.gov (United States)

    Lillo, Thomas M.; Chu, Henry S.; Harrison, William M.; Bailey, Derek

    2013-01-22

    Methods of forming composite materials include coating particles of titanium dioxide with a substance including boron (e.g., boron carbide) and a substance including carbon, and reacting the titanium dioxide with the substance including boron and the substance including carbon to form titanium diboride. The methods may be used to form ceramic composite bodies and materials, such as, for example, a ceramic composite body or material including silicon carbide and titanium diboride. Such bodies and materials may be used as armor bodies and armor materials. Such methods may include forming a green body and sintering the green body to a desirable final density. Green bodies formed in accordance with such methods may include particles comprising titanium dioxide and a coating at least partially covering exterior surfaces thereof, the coating comprising a substance including boron (e.g., boron carbide) and a substance including carbon.

  10. 78 FR 34132 - Certain Portable Electronic Communications Devices, Including Mobile Phones and Components...

    Science.gov (United States)

    2013-06-06

    ... INTERNATIONAL TRADE COMMISSION [Docket No 2958] Certain Portable Electronic Communications Devices, Including Mobile Phones and Components Thereof; Correction to Notice of Receipt of Complaint; Solicitation... of complaint entitled Certain Portable Electronic Communications Devices, Including Mobile Phones and...

  11. J. Genet. classic 227 NOTE: The pagination in the original included ...

    Indian Academy of Sciences (India)

    Unknown

    , December 2005. 227. NOTE: The pagination in the original included the reverse of plate 1 on p. 445, which was a blank. The blank is not included here, but the original page numbers have been retained.

  12. 78 FR 16865 - Certain Electronic Devices, Including Wireless Communication Devices, Portable Music and Data...

    Science.gov (United States)

    2013-03-19

    ..., Including Wireless Communication Devices, Portable Music and Data Processing Devices, and Tablet Computers... Samsung Electronics Co., Ltd. of Seoul, Republic of Korea, and Samsung Telecommunications America, LLC of... certain electronic devices, including wireless communication devices, portable music and data processing...

  13. 76 FR 19467 - Weyerhaeuser Company, Corporate Headquarters Including On-Site Leased Workers From Volt Services...

    Science.gov (United States)

    2011-04-07

    ... Employment and Training Administration Weyerhaeuser Company, Corporate Headquarters Including On-Site Leased... to workers of Weyerhaeuser Company, Corporate Headquarters, including on-site leased workers from Volt Services, Adecco, and Manpower, Federal Way, Washington. The workers supply corporate and...

  14. 78 FR 70584 - ATOS IT Solutions & Services, Inc., Billing and Collections Department, Including Workers Whose...

    Science.gov (United States)

    2013-11-26

    ... & Services, Inc., Billing and Collections Department, Including Workers Whose Unemployment Insurance (UI... Solutions & Services, Inc., Billing and Collections Department, Mason, Ohio. The workers are engaged in... of ATOS IT Solutions & Services, Inc., Billing and Collections Department, including workers whose...

  15. 26 CFR 1.61-2 - Compensation for services, including fees, commissions, and similar items.

    Science.gov (United States)

    2010-04-01

    ... (including Christmas bonuses), termination or severance pay, rewards, jury fees, marriage fees and other...). For the special rules relating to the includibility in an employee's gross income of an amount equal...

  16. 29 CFR 516.3 - Bona fide executive, administrative, and professional employees (including academic...

    Science.gov (United States)

    2010-07-01

    ... employees (including academic administrative personnel and teachers in elementary or secondary schools), and... professional employees (including academic administrative personnel and teachers in elementary or secondary... employed in the capacity of academic administrative personnel or teachers in elementary or secondary...

  17. 30 CFR 285.906 - What must my decommissioning application include?

    Science.gov (United States)

    2010-07-01

    ... provide one paper copy and one electronic copy of the application. Include the following information in... discharge of pollutants, including marine trash and debris, into the offshore waters. (k) A statement of...

  18. 77 FR 53234 - Certain Communication Equipment, Components Thereof, and Products Containing the Same, Including...

    Science.gov (United States)

    2012-08-31

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-817] Certain Communication Equipment, Components Thereof, and Products Containing the Same, Including Power Over Ethernet Telephones, Switches... products containing the same, including power over ethernet telephones, switches, wireless access points...

  19. 77 FR 36291 - Certain Communication Equipment, Components Thereof, and Products Containing the Same, Including...

    Science.gov (United States)

    2012-06-18

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-817] Certain Communication Equipment, Components Thereof, and Products Containing the Same, Including Power Over Ethernet Telephones, Switches... communication equipment, components thereof, and products containing the same, including power over ethernet...

  20. New records of nematodes from Korea, including Paratylenchus pandus n.sp. (Paratylenchidae nematoda).

    Science.gov (United States)

    Pinochet, J; Raski, D J

    1977-07-01

    Five new records of Paratylenchus, including P. pandus n.sp., are reported from Korea. An amended key to the genus is included on the basis of these findings. Macroposthonia tulagonovi is also reported with additional descriptions and illustrations.

  1. 12 CFR 563b.255 - What must the form of proxy include?

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false What must the form of proxy include? 563b.255... FROM MUTUAL TO STOCK FORM Standard Conversions Proxy Solicitation § 563b.255 What must the form of proxy include? The form of proxy must include all of the following: (a) A statement in bold face type...

  2. 21 CFR 179.30 - Radiofrequency radiation for the heating of food, including microwave frequencies.

    Science.gov (United States)

    2010-04-01

    ..., including microwave frequencies. 179.30 Section 179.30 Food and Drugs FOOD AND DRUG ADMINISTRATION... for the heating of food, including microwave frequencies. Radiofrequency radiation, including microwave frequencies, may be safely used for heating food under the following conditions: (a) The radiation...

  3. 25 CFR 115.616 - What information will be included in BIA's final decision?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What information will be included in BIA's final decision... Account § 115.616 What information will be included in BIA's final decision? BIA's final written decision to the parties involved in the proceeding will include: (a) BIA's decision to remove or retain the...

  4. Genes (including RNA editing information) - RMG | LSDB Archive [Life Science Database Archive metadata

    Lifescience Database Archive (English)

    Full Text Available switchLanguage; BLAST Search Image Search Home About Archive Update History Data List Contact us RMG Genes... (including RNA editing information) Data detail Data name Genes (including RNA edi... Site Policy | Contact Us Genes (including RNA editing information) - RMG | LSDB Archive ...

  5. 75 FR 74080 - In the Matter of Certain Liquid Crystal Display Devices, Including Monitors, Televisions, and...

    Science.gov (United States)

    2010-11-30

    ... COMMISSION Inv. No. 337-TA-749 In the Matter of Certain Liquid Crystal Display Devices, Including Monitors... sale within the United States after importation of certain liquid crystal display devices, including... importation of certain liquid crystal display devices, including monitors, televisions, and modules, and...

  6. 41 CFR 301-74.4 - What should cost comparisons include?

    Science.gov (United States)

    2010-07-01

    ... comparisons include? 301-74.4 Section 301-74.4 Public Contracts and Property Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES AGENCY RESPONSIBILITIES 74-CONFERENCE PLANNING Agency Responsibilities § 301-74.4 What should cost comparisons include? Cost comparisons should include...

  7. 20 CFR 416.929 - How we evaluate symptoms, including pain.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How we evaluate symptoms, including pain. 416....929 How we evaluate symptoms, including pain. (a) General. In determining whether you are disabled, we consider all your symptoms, including pain, and the extent to which your symptoms can reasonably be...

  8. 30 CFR 250.110 - What must I include in my welding plan?

    Science.gov (United States)

    2010-07-01

    ... prevent spark-producing activities (i.e., grinding, abrasive blasting/cutting and arc-welding) in... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What must I include in my welding plan? 250.110... must I include in my welding plan? You must include all of the following in the Welding Plan that you...

  9. 75 FR 26794 - Alticor, Inc., Including Access Business Group International LLC and Amway Corporation, Buena...

    Science.gov (United States)

    2010-05-12

    ..., Inc., Including Access Business Group International LLC and Amway Corporation, Buena Park, CA; Alticor, Inc., Including Access Business Group International LLC, and Amway Corporation, Ada, MI; Amended... of Alticor, Inc., including Access Business Group International LLC and Amway Corporation, Buena Park...

  10. 15 CFR 754.3 - Petroleum products not including crude oil.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Petroleum products not including crude... SUPPLY CONTROLS § 754.3 Petroleum products not including crude oil. (a) License requirement. As indicated... required to all destinations, including Canada, for the export of petroleum products, excluding crude oil...

  11. 7 CFR 319.56-20 - Apples and pears from Australia (including Tasmania) and New Zealand.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Apples and pears from Australia (including Tasmania... Fruits and Vegetables § 319.56-20 Apples and pears from Australia (including Tasmania) and New Zealand. Apples and pears from Australia (including Tasmania) and New Zealand may be imported only in accordance...

  12. The New version of Danish food composition database FRIDA including a case study on recipe calculation compared to a chemical analysis

    DEFF Research Database (Denmark)

    /French fry mix (n=16) had significant differences (Pfast food type with the largest difference between the two methods. Significance: Recipe calculation is a cost-effective alternative to chemical analysis in dietary assessment and nutrient labeling. But recipe...... and chemical analysis of fast food based on data from http://frida.fooddata.dk. Materials and methods: New fast food data in http://frida.fooddata.dk was based on 135 samples of ready to eat fast foods as burgers and sandwiches collected from fast food outlets, separated into their recipe components which were...... weighed. Typical components were bread, French fries, vegetables, meat, and dressings. The fast foods were analyzed and the content of energy, protein, saturated fat, iron, thiamin, potassium and sodium were compared to recipe calculation. Wilcoxon Signed Rank test, Spearman correlation coefficients...

  13. Leveraging two-way probe-level block design for identifying differential gene expression with high-density oligonucleotide arrays.

    Science.gov (United States)

    Barrera, Leah; Benner, Chris; Tao, Yong-Chuan; Winzeler, Elizabeth; Zhou, Yingyao

    2004-04-20

    To identify differentially expressed genes across experimental conditions in oligonucleotide microarray experiments, existing statistical methods commonly use a summary of probe-level expression data for each probe set and compare replicates of these values across conditions using a form of the t-test or rank sum test. Here we propose the use of a statistical method that takes advantage of the built-in redundancy architecture of high-density oligonucleotide arrays. We employ parametric and nonparametric variants of two-way analysis of variance (ANOVA) on probe-level data to account for probe-level variation, and use the false-discovery rate (FDR) to account for simultaneous testing on thousands of genes (multiple testing problem). Using publicly available data sets, we systematically compared the performance of parametric two-way ANOVA and the nonparametric Mack-Skillings test to the t-test and Wilcoxon rank-sum test for detecting differentially expressed genes at varying levels of fold change, concentration, and sample size. Using receiver operating characteristic (ROC) curve comparisons, we observed that two-way methods with FDR control on sample sizes with 2-3 replicates exhibits the same high sensitivity and specificity as a t-test with FDR control on sample sizes with 6-9 replicates in detecting at least two-fold change. Our results suggest that the two-way ANOVA methods using probe-level data are substantially more powerful tests for detecting differential gene expression than corresponding methods for probe-set level data.

  14. Leveraging two-way probe-level block design for identifying differential gene expression with high-density oligonucleotide arrays

    Directory of Open Access Journals (Sweden)

    Tao Yong-Chuan

    2004-04-01

    Full Text Available Abstract Background To identify differentially expressed genes across experimental conditions in oligonucleotide microarray experiments, existing statistical methods commonly use a summary of probe-level expression data for each probe set and compare replicates of these values across conditions using a form of the t-test or rank sum test. Here we propose the use of a statistical method that takes advantage of the built-in redundancy architecture of high-density oligonucleotide arrays. Results We employ parametric and nonparametric variants of two-way analysis of variance (ANOVA on probe-level data to account for probe-level variation, and use the false-discovery rate (FDR to account for simultaneous testing on thousands of genes (multiple testing problem. Using publicly available data sets, we systematically compared the performance of parametric two-way ANOVA and the nonparametric Mack-Skillings test to the t-test and Wilcoxon rank-sum test for detecting differentially expressed genes at varying levels of fold change, concentration, and sample size. Using receiver operating characteristic (ROC curve comparisons, we observed that two-way methods with FDR control on sample sizes with 2–3 replicates exhibits the same high sensitivity and specificity as a t-test with FDR control on sample sizes with 6–9 replicates in detecting at least two-fold change. Conclusions Our results suggest that the two-way ANOVA methods using probe-level data are substantially more powerful tests for detecting differential gene expression than corresponding methods for probe-set level data.

  15. In vitro bactericidal activity of blue light (465 nm) phototherapy on meticillin-susceptible and meticillin-resistant Staphylococcus pseudintermedius.

    Science.gov (United States)

    Schnedeker, Amy H; Cole, Lynette K; Lorch, Gwendolen; Diaz, Sandra F; Bonagura, John; Daniels, Joshua B

    2017-10-01

    Staphylococcus pseudintermedius is the most common cause of bacterial skin infections in dogs. Meticillin-resistant infections have become more common and are challenging to treat. Blue light phototherapy may be an option for treating these infections. The objective of this study was to measure the in vitro bactericidal activity of 465 nm blue light on meticillin-susceptible Staphylococcus pseudintermedius (MSSP) and meticillin-resistant Staphylococcus pseudintermedius (MRSP). We hypothesized that irradiation with blue light would kill MSSP and MRSP in a dose-dependent fashion in vitro as previously reported for meticillin-resistant Staphylococcus aureus (MRSA). In six replicate experiments, each strain [MSSP, n = 1; MRSP ST-71 (KM1381) n = 1; and MRSA (BAA-1680) n = 1] were cultivated on semisolid media, irradiated using a 465 nm blue light phototherapeutic device at the cumulative doses of 56.25, 112.5 and 225 J/cm 2 and incubated overnight at 35°C. Controls were not irradiated. Colony counts (CC) were performed manually. Descriptive statistics were performed and treatment effects assessed using the Wilcoxon-Mann-Whitney rank-sum test. Bonferroni-corrected rank-sum tests were performed for post hoc analysis when significant differences were identified. There was a significant decrease in CC with blue light irradiation at all doses for MRSA (P = 0.0006) but not for MSSP (P = 0.131) or MRSP (P = 0.589). Blue light phototherapy significantly reduced CC of MRSA, but not of MSSP or MRSP. The mechanism for the relative photosensitivity of the MRSA isolate is unknown, but is hypothesized to be due to an increased concentration of porphyrin in S. aureus relative to S. pseudintermedius, which would modulate blue light absorption. © 2017 ESVD and ACVD.

  16. Evaluation of cultural heritage in Posavje region by tourists and employees

    Directory of Open Access Journals (Sweden)

    Franc Brcar

    2017-02-01

    Full Text Available Purpose and Originality: This paper investigates tourism sustainability and examines the research problem of cultural and historical heritage sustainability in the Posavje region. The aim of this research paper is to evaluate the opinion of employees in tourist sector and tourists about tourism sustainability and their suggestions for improvement. The objective is to determine the level of sustainability of cultural and historical heritage. Method: Quantitative method with closed-ended questionnaire and qualitative method with open-ended questionnaire were used. Collected quantitative data were analyzed using frequency statistics, Spearman’s correlation coefficient, Wilcoxon rank-sum test, and Wilcoxon signed-rank test. Qualitative data were analyzed by three steps: data reduction, data display, and conclusion drawing/verification. Results: The results showed that maximizing benefits to cultural heritage and minimizing negative impact was rated more positively by tourists in comparison to employees in the tourist sector. The scores were rated between 2.72 and 4.05 on a scale from 1 (low level of sustainability to 5 (high level of sustainability. Society: We conclude that the level of tourism sustainability in Posavje region is not satisfactory and has to be improved. Limitations / further research: Respondents proposed a great number of ideas for improving tourism sustainability.

  17. Factors associated with willingness to participate in a vaccine clinical trial among elderly Hispanic patients

    Directory of Open Access Journals (Sweden)

    Sharon Rikin

    2017-09-01

    Full Text Available A population specific understanding of barriers and facilitators to participation in clinical trials could improve recruitment of elderly and minority populations. We investigated how prior exposure to clinical trials and incentives were associated with likelihood of participation in a vaccine clinical trial through a questionnaire administered to 200 elderly patients in an academic general internal medicine clinic. Wilcoxon signed rank sum test compared likelihood of participation with and without monetary incentives. Logistic regression evaluated characteristics associated with intent to participate in an influenza vaccine trial, adjusted for age, gender, language, and education history. When asked about likelihood of participation if there was monetary compensation, there was a 12.2% absolute increase in those reporting that they would not participate, with a significant difference in the distribution of likelihood before and after mentioning a monetary incentive (Wilcoxon signed rank test, p = 0.001. Those with previous knowledge of clinical trials (54.4% were more likely to report they would participate vs. those without prior knowledge (OR 2.5, 95% CI [1.2, 5.2]. The study highlights the importance of pre-testing recruitment materials and incentives in key group populations prior to implementing clinical trials. Keywords: Geriatrics, Clinical trials, Research design, Disparities

  18. Systems and Methods for Fabricating Structures Including Metallic Glass-Based Materials Using Low Pressure Casting

    Science.gov (United States)

    Hofmann, Douglas C. (Inventor); Kennett, Andrew (Inventor)

    2018-01-01

    Systems and methods to fabricate objects including metallic glass-based materials using low-pressure casting techniques are described. In one embodiment, a method of fabricating an object that includes a metallic glass-based material includes: introducing molten alloy into a mold cavity defined by a mold using a low enough pressure such that the molten alloy does not conform to features of the mold cavity that are smaller than 100 microns; and cooling the molten alloy such that it solidifies, the solid including a metallic glass-based material.

  19. Numerical Acoustic Models Including Viscous and Thermal losses: Review of Existing and New Methods

    DEFF Research Database (Denmark)

    Andersen, Peter Risby; Cutanda Henriquez, Vicente; Aage, Niels

    2017-01-01

    This work presents an updated overview of numerical methods including acoustic viscous and thermal losses. Numerical modelling of viscothermal losses has gradually become more important due to the general trend of making acoustic devices smaller. Not including viscothermal acoustic losses...... in such numerical computations will therefore lead to inaccurate or even wrong results. Both, Finite Element Method (FEM) and Boundary Element Method (BEM), formulations are available that incorporate these loss mechanisms. Including viscothermal losses in FEM computations can be computationally very demanding, due...... and BEM method including viscothermal dissipation are compared and investigated....

  20. 75 FR 6355 - Manufacturing Extension Partnership (MEP) Availability of Funds for Three Regions Including the...

    Science.gov (United States)

    2010-02-09

    ... working with manufacturers. The proposal should include plans for integration into the MEP national system... Center? i. Organizational Structure. Completeness and appropriateness of the organizational structure...

  1. Distributed Control of Nonlinear Aircraft Structures Including Aerodynamic and Temperature Interactions

    National Research Council Canada - National Science Library

    Tzou, H

    2004-01-01

    .... Distributed sensing/actuation, thermoelectromechanical/control equations and boundary conditions including elastic, temperature, and piezoelectric couplings are derived and applied to distributed...

  2. Speech-Language Therapists' Process of Including Significant Others in Aphasia Rehabilitation

    Science.gov (United States)

    Hallé, Marie-Christine; Le Dorze, Guylaine; Mingant, Anne

    2014-01-01

    Background: Although aphasia rehabilitation should include significant others, it is currently unknown how this recommendation is adopted in speech-language therapy practice. Speech-language therapists' (SLTs) experience of including significant others in aphasia rehabilitation is also understudied, yet a better understanding of clinical…

  3. 25 CFR 1000.162 - What is included in a self-governance compact?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false What is included in a self-governance compact? 1000.162...-DETERMINATION AND EDUCATION ACT Negotiation Process for Annual Funding Agreements Negotiating A Self-Governance Compact § 1000.162 What is included in a self-governance compact? A model format for self-governance...

  4. 25 CFR 170.411 - What may a long-range transportation plan include?

    Science.gov (United States)

    2010-04-01

    ... preservation planning to identify important issues and develop a transportation plan that is sensitive to... 25 Indians 1 2010-04-01 2010-04-01 false What may a long-range transportation plan include? 170... Long-Range Transportation Planning § 170.411 What may a long-range transportation plan include? A...

  5. 77 FR 42764 - Certain Integrated Circuits, Chipsets, & Products Containing Same Including Televisions; Notice...

    Science.gov (United States)

    2012-07-20

    ..., Chipsets, & Products Containing Same Including Televisions; Notice of Request for Statements on the Public... against certain integrated circuits, chipsets, and products containing the same including televisions...'') in a prominent place on the cover page and/or the first page. (See Handbook for Electronic Filing...

  6. 12 CFR 563b.105 - What information must I include in my business plan?

    Science.gov (United States)

    2010-01-01

    ... information must I include in my business plan? (a) Prior to filing an application for conversion, you must adopt a business plan reflecting your intended plans for deployment of the proposed conversion proceeds. Your business plan is required, under § 563b.150, to be included in your conversion application. At a...

  7. 34 CFR 86.100 - What must the IHE's drug prevention program include?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What must the IHE's drug prevention program include? 86.100 Section 86.100 Education Office of the Secretary, Department of Education DRUG AND ALCOHOL ABUSE PREVENTION Institutions of Higher Education § 86.100 What must the IHE's drug prevention program include? The IHE's drug prevention program must, a...

  8. 12 CFR 563b.270 - What must I include in my proxy statement?

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false What must I include in my proxy statement? 563b... CONVERSIONS FROM MUTUAL TO STOCK FORM Standard Conversions Proxy Solicitation § 563b.270 What must I include in my proxy statement? (a) Content requirements. You must prepare your proxy statement in compliance...

  9. 30 CFR 250.527 - What must I include in my casing pressure request?

    Science.gov (United States)

    2010-07-01

    ... request? 250.527 Section 250.527 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR... Operations Casing Pressure Management § 250.527 What must I include in my casing pressure request? The following information must be included in the casing pressure request: (a) API number; (b) Lease number; (c...

  10. 75 FR 71458 - Cranberry Lumber Company Including Workers of the Following Operating Entities: Butternut One...

    Science.gov (United States)

    2010-11-23

    ...,910B] Cranberry Lumber Company Including Workers of the Following Operating Entities: Butternut One, Ltd., Cranberry Resources, LLC., and Cranberry Hardwoods, Inc. Incuding On-Site Leased Workers From Stafftrak Beckley, WV, Cranberry Lumber Company Including Workers of Greenbrier Forest Products, Inc. Smoot...

  11. 25 CFR 20.401 - What is included under Services to Children, Elderly, and Families?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is included under Services to Children, Elderly, and... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.401 What is included under Services to Children, Elderly, and Families? Services to Children, Elderly, and...

  12. 20 CFR 404.1322 - Post-World War II service included.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Post-World War II service included. 404.1322... DISABILITY INSURANCE (1950- ) Wage Credits for Veterans and Members of the Uniformed Services Post-World War II Veterans § 404.1322 Post-World War II service included. Your service was in the active service of...

  13. 78 FR 12358 - UBS Financial Services, Inc., Wealth Management Americas Operations, Including On-Site Leased...

    Science.gov (United States)

    2013-02-22

    ..., Inc., Wealth Management Americas Operations, Including On-Site Leased Workers From Leafstone... Services, Inc., Wealth Management Americas Operations (UBS), Weehawken, New Jersey. The workers are engaged... to include all leased workers on-site at UBS Financial Services, Inc., Wealth Management Americas...

  14. 78 FR 54487 - Abbott Laboratories; Diagnostic-Hematology; Including On-Site Leased Workers From Manpower...

    Science.gov (United States)

    2013-09-04

    ...; Diagnostic--Hematology; Including On-Site Leased Workers From Manpower Service Group and ATR International... February 22, 2013, applicable to workers of Abbott Laboratories, Diagnostic--Hematology division, including... firm. The workers were engaged in activities related to the production of hematology reagents and...

  15. 42 CFR 493.941 - Hematology (including routine hematology and coagulation).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Hematology (including routine hematology and....941 Hematology (including routine hematology and coagulation). (a) Program content and frequency of challenge. To be approved for proficiency testing for hematology, a program must provide a minimum of five...

  16. 38 CFR 36.4224 - Refinancing existing manufactured home loan including purchase of lot.

    Science.gov (United States)

    2010-07-01

    ... manufactured home loan including purchase of lot. 36.4224 Section 36.4224 Pensions, Bonuses, and Veterans... manufactured home loan including purchase of lot. (a) A veteran may refinance (38 U.S.C. 3712(a)(1)(G)) an... conjunction with a loan to acquire a suitable lot on which that manufactured home is or will be located...

  17. 75 FR 9437 - Wacker Chemical Corporation Wacker Polymers Division a Subsidiary of Wacker Chemie AG Including...

    Science.gov (United States)

    2010-03-02

    ... Chemical Corporation Wacker Polymers Division a Subsidiary of Wacker Chemie AG Including On-Site Leased.... and Yoh Managed Staffing South Brunswick, NJ; Wacker Chemical Corporation Wacker Polymers Division a... of Wacker Chemical Corporation, Wacker Polymers Division, a subsidiary of Wacker Chemie AG, including...

  18. 20 CFR 410.450 - Death due to pneumoconiosis, including statutory presumption.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Death due to pneumoconiosis, including... COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.450 Death due to pneumoconiosis, including statutory presumption...

  19. 75 FR 76040 - Weyerhaeuser Company Corporate Headquarters Including On-Site Leased Workers From Volt Services...

    Science.gov (United States)

    2010-12-07

    ... Employment and Training Administration Weyerhaeuser Company Corporate Headquarters Including On-Site Leased... Weyerhaeuser Company, Corporate Headquarters, including on-site leased workers from Volt Services, Adecco, and... subject firm. The workers supply corporate and administrative services for the firm. The company reports...

  20. 75 FR 39045 - Hewlett-Packard Company Division of Corporate Administration and Shared Services Including On...

    Science.gov (United States)

    2010-07-07

    ... Employment and Training Administration Hewlett-Packard Company Division of Corporate Administration and... Division of Corporate Administration and Shared Services Including On- Site Leased Workers From Manpower... Company, Division of Corporate Administration and Shared Services, including on- site leased workers from...