Aeromedical decision making in attention-deficit/hyperactivity disorder.

Science.gov (United States)

Fitzgerald, David J P; Navathe, Pooshan D; Drane, A Michael

2011-05-01

Attention-deficit/hyperactivity disorder is a problematic diagnosis in the context of aeromedical certification. Certain characteristics of the disorder such as impaired attention potentially affect the safe conduct of flying. Pharmacological treatment with stimulants also has issues surrounding short half-lives and effects on the recognition of fatigue. This article gives a broad overview of the issues involved and provides certification guidelines as adopted in the Australian Civil Aviation Safety Authority which may be helpful if adopted by other certification bodies.

Aero-medical evacuation from the second Israel-Lebanon war: a descriptive study.

Science.gov (United States)

Schwartz, Dagan; Resheff, Avram; Geftler, Alex; Weiss, Aviram; Birenbaum, Erez; Lavon, Ophir

2009-05-01

The second Lebanon war started as a limited operation and progressed to a large-scale campaign. Most of the fighting took place in mountainous villages and small towns inhabited with civilians. The Israeli Defense Forces (IDF) Airborne rescue and evacuation unit is charged with air evacuation of soldiers and civilians in times of peace, limited conflict, and war. We describe this unit's activities in the second Lebanon war, analyzing injury, treatment, and evacuation characteristics Data were collected from flight medical reports, debriefings of aero-medical team members (usually immediately upon return from mission), ground units medical reports and debriefings, and hospital records. 725 IDF soldiers were injured and 117 killed either in Lebanon or near the Israeli-Lebanese border during the war. A total of 338 (46%) were evacuated in 95 airlifts (averaging 4.5 evacuees per airlift) from the fighting zones or the border. Air evacuation used dedicated helicopters with advanced care capacities, and most victims were evacuated straight from the battlefield, as the fighting was ensuing. Many wounded first received advanced medical care upon the arrival of the aero-medical teams. In military operations within civilian populated areas with threats to ground transport, air evacuation can sometimes be the only readily available option. Providing timely ground advanced medical care proved difficult in many instances. Thus, for many, the rescue helicopter was the first point of access to such care. Aero-medical aircrafts and personnel faced threats from gunfire and missiles, causing both delays in evacuation and a high average number of evacuees per airlift. This article proposes ways of coping with situations in which similar rescue and evacuation problems are likely.

Aeromedical solutions for aerospace safety.

Science.gov (United States)

Kapoor, Pawan; Gaur, Deepak

2017-10-01

All facets of activity in the speciality of Aviation Medicine are essentially aimed at enhancing aerospace safety. This paper highlights some innovative changes brought about by Aerospace Medicine in the three major fields of the speciality namely, medical evaluation, aeromedical training and research. Based on lab and field studies, military aircrew are now permitted flying with Modifinil as 'Go' Pill and Zolpidem as 'No-Go' Pill during sustained operations. Several other drugs for disabilities like Hypertension and CAD are now permitted for aviators. Comprehensive revision of policy permitting early return to flying is an on-going process. OPRAM courses for all three streams of aircrew in IAF have contributed to reduce aircraft accident rates. Human Engineering Consultancy and expert advice is provided by specialists at IAM as well as those in the field. In future, the country needs to provide better post-service opportunities to aerospace medicine specialists. This, in turn, will attract bright young minds to the specialty. The ISRO Humanin-Space programme will be an exciting challenge for all in this unique field. Aerospace Medicine continues to provide aerospace safety solutions to the IAF and the aviation industry. The nation needs to continue to utilize and support this specialty.

On shift simulation in aeromedical operations - making it work

Directory of Open Access Journals (Sweden)

John Glasheen

2017-06-01

Full Text Available Patient care in the prehospital and retrieval medicine (PHARM environment presents many technical and non-technical challenges. Clinicians are frequently required to perform complex interventions in a time critical and resource limited setting. Intensive training is required prior to operational deployment, and ongoing training is vital to ensure optimal team performance in the delivery of high quality patient care. Regular simulation training with high situational fidelity is valuable in developing and maintaining excellence in PHARM. We describe the methods employed by two Australian aeromedical retrieval services to facilitate daily on shift simulation.

Biodiesel production and antioxidant capability from seeds of salicornia begelovii collected from al jubail, eastern province, saudi arabia

International Nuclear Information System (INIS)

Rashed, S.A.; Ibrahim, M.M.; Hatata, M.A.

2016-01-01

Salicornia begelovii Torr displays excessive biotechnological prospective as a salt-water irrigated crop. Qualitative and quantitative compositions of fatty acids were analyzed in the seeds of Salicornia begelovii collected from the eastern region, Al Jubail, Saudi Arabia. Hexane extraction of the seed oil from Salicornia begelovii yielded 29% of total lipids. The GC-MS (Gas Chromatography-Mass Spectroscopy) investigation of the hexane extracts revealed five major peaks for the seed oil: 72.5 wt.% linoleic-6 acid (18:2), 7.4 wt.% palmitic acid (16:0), 13.3 wt.% oleic acid (18:1), 2.14 wt.% stearic acid (18:0) and 2.3 wt.% linolenic-3 acid (18:3). The quantity of the both saturated palmitic and stearic acids amounted (9.18%) in S. begelovii seed oil. The antioxidant capability of S. begelovii seed oil were determined and expressed by hydroxyl radical scavenging assay, nitric oxide (NO) scavenging activity and radical scavenging effects of the extract on DPPH free radical were studied. The composition of the oil was nutritive and medical health value was high, in addition to, it's composition very similar to that of safflower oil. No unwanted fatty acid constituents were established in S. begelovii seed oil, and it could be suggested for biofuel fabrication. (author)

Aeromedical Hazard Comparison of FAA Medically Certified Third-Class and Medically Uncertified Pilots.

Science.gov (United States)

Ricaurte, Eduard M; Mills, William D; DeJohn, Charles A; Laverde-Lopez, Maria C; Porras-Sanchez, Daniel F

2016-07-01

Since 2004, in the United States, light sport aircraft (LSA) and some aircraft with standard airworthiness certificates can be operated for recreational purposes with a valid state driver's license rather than a Federal Aviation Administration (FAA)-issued aeromedical certificate. There have been recent efforts to allow operation of much larger, heavier, faster, and more complex aircraft without requiring a medical certificate. The primary objective of this research was to compare hazards to flight safety identified in fatally injured pilots required to possess a valid FAA third-class medical certificate to hazards in fatally injured pilots who were not required to possess a valid medical certificate. A search of all fatal U.S. aircraft accidents in the FAA Medical ANalysis and TRAcking (MANTRA) registry between January 1, 2011, and April 30, 2014, identified 1084 individuals. A review of accident pilots' medical, autopsy, and toxicological data was conducted. After applying exclusion criteria, 467 pilots remained, including 403 medically certified and 64 medically uncertified pilots. A significant difference was found in a surrogate measure for risk between medically certified and uncertified pilots (25% vs. 59%). This difference remained significant after adjustment for age. No significant difference was found in the proportions of hazards identified on toxicological review. The results of this study suggest that the risk of an adverse medical event is reduced in pilots required to possess a valid medical certificate. Ricaurte EM, Mills WD, DeJohn CA, Laverde-Lopez MC, Porras-Sanchez DF. Aeromedical hazard comparison of FAA medically certified third-class and medically uncertified pilots. Aerosp Med Hum Perform. 2016; 87(7):618-621.

Evaluation of Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma

Science.gov (United States)

2017-02-01

long range aero-medical evacuation in hypobaric environments on the physiology and organ function of injured warfighters, thus potentially and...currently ongoing. REPORTABLE OUTCOMES: Steve Chun, MD; Ashraful Haque, MD; Brittany Hazzard, BS; Saha Biswajit, MD, Martin Harssema, MD, Charles Auker...Scultetus MD; Ashraful Haque, MD; Brittany Hazzard, BS; Saha Biswajit, MD; Steve Chun, MD; Martin Harssema, MD; Charles Auker, MD, PhD; Debra Malone

[Aeromedical evacuation of critically ill patients in developing countries A retrospective study on 244 patients in Djibouti].

Science.gov (United States)

Bordes, J; Loheas, D; Benois, A

2015-01-01

The pratice of intensive care in Africa is marked by a wide variety of health care delivery. Only a few centers offer specialized intensive care units, as cardiac or neurological units. That may explain the need for aeromedical evacuations for patients whose condition exceeds local capacity. Our objective was to assess whether the proportion of patients admitted to intensive care and evacuated had increased between 1997 and 2013 in a developing country, Djibouti. We examined the activity register of Bouffard Hospital intensive care unit in Djibouti to determine the number and characteristics of patients evacuated by air ambulance during a 16 years period. From January 1997 to December 2013, a total of 244 patients were evacuated. The evacuation rate was 5.74ù of the patients admitted to the entire duration of the study. The rate of patients evacuated was not different between 1997 and 2013 (5,69ù versus 8,33ù respectively, p = 0,269). However, the rate of djiboutian evacuated patients was statistically different between 1997 and 2013 (0,96ù versus 4,46ù, p = 0,02). The main causes were severe trauma injuries, cardiovascular diseases and neurological diseases. The aeromedical evacuation of a critically ill patient in a developing country is a process requiring heavy logistics and depending on the medical skills available in the area, and financial resources that can be implemented for the patient. Our study shows that medical evacuations in favor of Djiboutian patients are marginal but are increasing over the past decade.

An Occupational Paradox: Why Do We Love Really Tough Jobs?

Science.gov (United States)

Pierce, Penny F; McNeill, Margaret M; Dukes, Susan F

2018-04-01

Sometimes we come upon unexpected or counterfactual results during research that make us wonder and lead us into unknown territory. Such was the experience of a team of Air Force researchers exploring aeromedical evacuation crew members' experiences of safety and patient care concerns throughout the en route care system. To explore what it is about the aeromedical evacuation crew members' occupation that generates a strong motivation to the mission despite the demands it places on its workers. Eight focus groups were conducted with 69 Air Force aeromedical evacuation and staging facility active duty, Air National Guard, and Air Force Reserve Command nurses and medical technicians between May 2012 and April 2013 at 5 locations in the contiguous and outside the contiguous United States. An unexpected finding was that despite the austere nature of the Air Force en route care mission and the acuity of the patients being transported, nurses and medical technicians were passionate about bringing home the wounded, sick, and injured warriors and were committed to providing the best and safest care possible. It is plausible that a high level of commitment and mission focus contributes significantly to the safety and well-being of those transported. Still, we must wonder why nurses and technicians voluntarily serve in such a demanding and sometimes dangerous occupation, and yet find such a high degree of satisfaction and contentment with this type of job. ©2018 American Association of Critical-Care Nurses.

Emergency Aeromedical Services in Ireland – A Single-Centre Study in 2014

LENUS (Irish Health Repository)

Sheridan, G.A.

2017-03-01

This retrospective analysis includes patients requiring Emergency Aeromedical Services (EAS) in 2014. The aim of this paper is to evaluate the HEMS service in a single centre and to accurately assess whether certain internationally validated criteria can predict admission rates better than the currently used criteria. Using the American College of Surgeons (ACS) trauma-related dispatch criteria, each case was retrospectively evaluated. Results showed the mean total criteria met were 2.73 (σ=0.88) and 1.45 (σ=0.82) in admitted and discharged patients respectively. The total criteria met had a significant predictive value on admission rates (p<0.05). Increased admission rates were shown in patients with a high Mechanism of Injury (MOI) (p<0.05). False positive rates of HEMS transfer were higher when applying the current criteria compared to the ACS criteria. ACS total criteria can predict admission in HEMS patients with a higher specificity than currently used guidelines.

[Doctor, may I travel in space? Aeromedical considerations regarding commercial suborbital space flights].

Science.gov (United States)

Haerkens, Marck H T M; Simons, Ries; Kuipers, André

2011-01-01

Within a few years, the first commercial operators will start flying passengers on suborbital flights to the verge of space. Medical data on the effects of space journeys on humans have mainly been provided by professional astronauts. There is very little research into the aeromedical consequences of suborbital flights for the health of untrained passengers. Low air pressure and oxygen tension can be compensated for by pressurising the spacecraft or pressure suit. Rapid changes in gravitational (G-)force pose ultimate challenges to cardiovascular adaptation mechanisms. Zero-gravity and G-force may cause motion sickness. Vibrations and noise during the flight may disturb communication between passengers and crew. In addition, the psychological impact of a suborbital flight should not be underestimated. There are currently no legal requirements available for medical examinations for commercial suborbital flights, but it seems justifiable to establish conditions for potential passengers' states of health.

Joint Use of the MAB-II and MicroCog for Improvements in the Clinical and Neuropsychological Screening and Aeromedical Waiver Process of Rated USAF Pilots

Science.gov (United States)

2010-01-01

medical flight screening and the aeromedical waiver process ( Olea & Ree, 1994; Ree & Carretta, 1996; Ree, Carretta, & Teachout, 1995). Currently, the...Student pilots with high scores on ability tests are more likely to complete training ( Olea & Ree, 1994; Ree & Carretta, 1996; Ree, Carretta, & Teachout...Matrix differential calculus with applications in statistics and econometrics. New York, NY: John Wiley. Olea , M., & Ree, M.J. (1994

Infrastructure development to support the hydrocarbon industry

International Nuclear Information System (INIS)

Mack, T.

1993-01-01

Tengiz and Jubail represent areas in which the exploitation of oil and gas resources have, and are, providing enormous opportunities for regional development. Each has required a vision of the future and an understanding that infrastructure input is very broadly defined. Tengiz and Jubail are extreme examples. There are probably no cases in the Americas that will exactly mirror these. But opportunities for oil and gas development here may share some of these projects characteristics - extraction from remote areas, challenging transportatoin needs, and perhaps most importantly, opportunities for related industrial and economic development. Just as Jubail's master plan was part of a larger Saudi vision, oil and gas infrastructure planning can support Latin and North American countries individual visions of their nation's future. Where regional economic integration and interaction is increasing, there are even greater opportunities for good infrastructure planning. In some cases, such economic integration will provide the key which will unlock oil and gas development. Once these keys are provided - be it through the intangible innovations of creative project finance or tangible links through roadways, pipeline and rail - the opening will provide real chances to develop the infrastructure of the entire region

Endotracheal tube and laryngeal mask airway cuff volume changes with altitude: a rule of thumb for aeromedical transport.

Science.gov (United States)

Mann, Catherine; Parkinson, Neil; Bleetman, Anthony

2007-03-01

Helicopters and light (unpressurised) aircraft are used increasingly for the transport of ventilated patients. Most of these patients are ventilated through endotracheal tubes (ETTs), others through laryngeal mask airways (LMAs). The cuffs of both ETTs and LMAs inflate with increases in altitude as barometric pressure decreases (30 mbar/1000 feet). Tracheal mucosa perfusion becomes compromised at a pressure of approximately 30 cm H2O; critical perfusion pressure is 50 cm H2O. The change in dimensions of the inflated cuffs of a size 8 ETT and a size 5 LMA were measured with digital callipers at 1000 feet intervals in the unpressurised cabin of an Agusta 109 helicopter used by the Warwickshire and Northamptonshire Air Ambulance. A linear expansion in cuff dimensions as a function of altitude increase was identified. For ETTs, a formula for removal of air from the cuff with increasing altitude was calculated and is recommended for use in aeromedical transfers. This is 1/17x1.1 = 0.06 ml/1000 foot ascent/ml initial cuff inflation. The data for LMA cuff expansion failed to show significant correlation with altitude change. Further work is required to determine a similar rule of thumb for LMA cuff deflation.

Staging of prostate cancer: an update

International Nuclear Information System (INIS)

Vallejos, J.; Alvarez, C.; Mariluis, C.; Paganini, L.; González, C.; De Luca, S.; Dieguez, A.; Villaronga, A.

2013-01-01

In our country prostate cancer is the most common malignancy in older men. An accurate staging is very important to establish treatment strategies.This article presents the 7th edition TNM staging system for prostate cancer, effective January 1, 2010. This has undergone major changes over the 6th edition. (authors) [es

An Analysis of Kohlberg's "Stage 4 1/2" within an Enhanced Framework of Moral Stages.

Science.gov (United States)

Minnameier, Gerhard

This paper discusses a well-known problem of stage categorization within Kohlberg's theory of moral stages (L. Kohlberg, 1973), that of "Stage 4 1/2." Some subjects previously scored at stage 4 in Kohlberg's framework took on some characteristics of stage 2 reasoning, which suggested the possibility of regression. To reconcile this…

Medical Evacuation from Vietnam of an Elderly with Tuberculosis Spondylitis

Directory of Open Access Journals (Sweden)

Ying-Hua Shieh

2007-09-01

Full Text Available Despite the growth in economy in Vietnam, the infrastructure of dependable medical care is still lacking. Therefore, aeromedical evacuation of patients to other countries for further medical interventions has become an important medical service in the region. We report a case where an elderly man who was aeromedically evacuated from Ho Chi Minh City, Vietnam to Taipei Medical University–Municipal Wan Fang Hospital in Taipei, Taiwan. The patient developed a sudden onset of quadriplegia because of an epidural abscess at the cervical spine C6–C7. Antituberculous medication was prescribed for suspected tuberculous spondylitis, because his cerebral spinal fluid showed elevated white blood cells with a predominance of lymphocytes, and mildly elevated total protein. However, whole body tumor scan (67Ga mCi and whole body bone scan (99mTc methylene diphosphonate, 25 mCi did not reveal any specific results. Surgical intervention was arranged because of cervical spine instability and the need for a diagnostic biopsy. Adenocarcinoma of the prostate was found incidentally and was treated with bilateral orchiectomy and radiation therapy. This was the first medical evacuation by the Family Medical Practice group in Ho Chi Minh City, Vietnam to Taiwan.

75 FR 43919 - Energy and Infrastructure Mission to Saudi Arabia: Third City Stop Added to the Trade Mission...

Science.gov (United States)

2010-07-27

... and Dhahran; and Networking receptions in two cities of the trade mission. Proposed Mission Timetable... Saudi Arabia: Third City Stop Added to the Trade Mission Itinerary AGENCY: International Trade... expansion at Jubail Industrial City II with around 20 petrochemical and infrastructure projects worth more...

How Should Air Force Expeditionary Medical Capabilities Be Expressed

Science.gov (United States)

2009-01-01

Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Sci- ence, Vol. 4, 2006, pp. 135–146; Sarah A. Lister, Hurricane Katrina: The Public...setting this might mean releasing the patient to a nursing home. In a domestic civilian disaster setting, it may mean releasing the patient to some...described below. The Mobile Aeromedical Staging Facility (MASF) is a 15-person, communications-capable UTC that provides supportive/resuscita- tive nursing

Juvenile nasopharyngeal angiofibroma staging: An overview.

Science.gov (United States)

Alshaikh, Nada Ali; Eleftheriadou, Anna

2015-06-01

Staging of tumors is very important in treatment and surgical decision making, as well as in predicting disease recurrence and prognosis. This review focuses on the different available classifications of juvenile nasopharyngeal angiofibroma (JNA) and their impact on the evaluation, management, and prognosis of JNA. The literature was reviewed, and publications on JNA staging were examined. Our MEDLINE search of the entire English-language literature found no review article on the current available staging systems for JNA. In this article, we review the common JNA classification systems that have been published, and we discuss some of their advantages and disadvantages. The most commonly used staging systems for JNA are the Radkowski and the Andrews-Fisch staging systems. However, some newer staging systems that are based on advances in technology and surgical approaches-the Onerci, INCan, and UPMC systems-have shown promising utility, and they will probably gain popularity in the future.

The effects of napping on night shift performance : final report.

Science.gov (United States)

2000-02-01

This study represents a collaborative effort between the Federal Aviation Administrations Civil Aeromedical Institute and the US Army Aeromedical Research Laboratory to investigate the effects of napping on the midnight shift as a potential counte...

Aeromedical Aspects of Melatonin-An Overview

National Research Council Canada - National Science Library

Sanders, Donald

1998-01-01

.... This variation has suggested the possibility of a regulatory function in day/night dependent physiological processes, such as sleep, and has led scientists to explore the effects of administered...

75 FR 21598 - Energy and Infrastructure Mission to Saudi Arabia

Science.gov (United States)

2010-04-26

... Riyadh and Dhahran; and Networking receptions in two cities of the trade mission. Proposed Mission... (Sipchem) complex, which will produce synthetic fibers. The planned expansion at Jubail Industrial City II.... Among Saudi Arabia's super-projects are as many as six ``economic cities,'' to be completed by the year...

Sabkha Trafficability,

Science.gov (United States)

1981-01-01

southwest Arabian Gulf (Figure 2). Between Ras Ghanda in the east to the Qatar peninsula on the west an essentially unbroken coastal sabkha stretches for...were found embedded in lightly cemented surficial crusts of the end of a 20 year old jetty in Qatar . It may also be of interest to note that beer cans...flows underground in aquifers . The uppermost aquifer in Jubail is the Neogene Formation, sur- ficial unconsolidated aeolian and marine calcareous

MRI in local staging of rectal cancer: an update

Science.gov (United States)

Tapan, Ümit; Özbayrak, Mustafa; Tatlı, Servet

2014-01-01

Preoperative imaging for staging of rectal cancer has become an important aspect of current approach to rectal cancer management, because it helps to select suitable patients for neoadjuvant chemoradiotherapy and determine the appropriate surgical technique. Imaging modalities such as endoscopic ultrasonography, computed tomography, and magnetic resonance imaging (MRI) play an important role in assessing the depth of tumor penetration, lymph node involvement, mesorectal fascia and anal sphincter invasion, and presence of distant metastatic diseases. Currently, there is no consensus on a preferred imaging technique for preoperative staging of rectal cancer. However, high-resolution phased-array MRI is recommended as a standard imaging modality for preoperative local staging of rectal cancer, with excellent soft tissue contrast, multiplanar capability, and absence of ionizing radiation. This review will mainly focus on the role of MRI in preoperative local staging of rectal cancer and discuss recent advancements in MRI technique such as diffusion-weighted imaging and dynamic contrast-enhanced MRI. PMID:25010367

Shakespeare Page to Stage: An Active Approach to "Othello."

Science.gov (United States)

Thomas, Peter

1994-01-01

Presents an account of how one English teacher taught William Shakespeare's "Othello" through dramatics in a challenging way. Considers how teachers of drama might discuss props, stage directions, and the proper handling of Desdemona's handkerchief. Explains how teachers should try to take the plays from "page to stage." (HB)

An experimentally validated simulation model for a four-stage spray dryer

DEFF Research Database (Denmark)

Petersen, Lars Norbert; Poulsen, Niels Kjølstad; Niemann, Hans Henrik

2017-01-01

mathematical model is an index-1 differential algebraic equation (DAE) model with 12 states, 9 inputs, 8 disturbances, and 30 parameters. The parameters in the model are identified from well-excited experimental data obtained from the industrialtype spray dryer. The simulated outputs ofthe model are validated...... is divided into four consecutive stages: a primary spray drying stage, two heated fluid bed stages, and a cooling fluid bed stage. Each of these stages in the model is assumed ideally mixed and the dynamics are described by mass- and energy balances. These balance equations are coupled with constitutive...... equations such as a thermodynamic model, the water evaporation rate, the heat transfer rates, and an equation for the stickiness of the powder (glass transition temperature). Laboratory data is used to model the equilibrium moisture content and the glass transition temperature of the powder. The resulting...

Vane clocking effects in an embedded compressor stage

Science.gov (United States)

Key, Nicole Leanne

The objective of this research was to experimentally investigate the effects of vane clocking, the circumferential indexing of adjacent vane rows with similar vane counts, in an embedded compressor stage. Experiments were performed in the Purdue 3-Stage Compressor, which consists of an IGV followed by three stages. The IGV, Stator 1, and Stator 2 have identical vane counts of 44, and the effects of clocking were studied on Stage 2. The clocking configuration that located the upstream vane wake on the Stator 2 leading edge was identified with total pressure measurements at the inlet to Stator 2 and confirmed with measurements at the exit of Stator 2. For both loading conditions, the total temperature results showed that there was no measurable change associated with vane clocking in the amount of work done on the flow. At design loading, the change in stage efficiency with vane clocking was 0.27 points between the maximum and minimum efficiency clocking configurations. The maximum efficiency configuration was the case where the Stator 1 wake impinged on the Stator 2 leading edge. This condition produced a shallower and thinner Stator 2 wake compared to the clocking configuration that located the wake in the middle of the Stator 2 passage. By locating the Stator 1 wake at the leading edge, it dampened the Stator 2 boundary layer response to inlet fluctuations associated with the Rotor 2 wakes. At high loading, the change in Stage 2 efficiency increased to 1.07 points; however, the maximum efficiency clocking configuration was the case where the Stator 1 wake passed through the middle of the downstream vane passage. At high loading, the flow physics associated with vane clocking were different than at design loading because the location of the Stator 1 wake fluid on the Stator 2 leading edge triggered a boundary layer separation on the suction side of Stator 2 producing a wider and deeper wake. Vane clocking essentially affects the amount of interaction between the

New successful one-step surgical repair for apple peel atresia

Directory of Open Access Journals (Sweden)

Machmouchi M

2011-11-01

Full Text Available Mahmoud MachmouchiDepartment of Pediatrics, Royal Commission Hospital, Jubail, Saudi ArabiaAbstract: A new successful surgical approach in two identical twins delivered with intestinal atresia, “apple peel” type is reported. This technique consists of: (1 an end-to-end oblique primary anastomosis with single layer inverted 5/0 Vicryl® sutures (Ethicon, Inc, Somerville, NJ; (2 proximal tube jejunostomy using Foley catheter, size 10 French, inserted through a stab wound in the left upper quadrant and entering the proximal dilated loop at about 10 cm proximal from its blind end (site of anastomosis; and (3 transanastomotic stenting using feeding tube, size 6 French, exteriorized in conjunction with the Foley catheter and reaching the lumen of the distal loop for more than 20 cm. The postoperative course was uneventful and progressive oral feed became ad libitum around day 40 postoperative. This procedure is simple, performed in one stage, and responds to the most obligatory requirements of this congenital malformation.Keywords: proximal jejunal atresia, intestinal atresia, surgical repair, anastomosis

Teaching basic life support with an automated external defibrillator using the two-stage or the four-stage teaching technique.

Science.gov (United States)

Bjørnshave, Katrine; Krogh, Lise Q; Hansen, Svend B; Nebsbjerg, Mette A; Thim, Troels; Løfgren, Bo

2018-02-01

Laypersons often hesitate to perform basic life support (BLS) and use an automated external defibrillator (AED) because of self-perceived lack of knowledge and skills. Training may reduce the barrier to intervene. Reduced training time and costs may allow training of more laypersons. The aim of this study was to compare BLS/AED skills' acquisition and self-evaluated BLS/AED skills after instructor-led training with a two-stage versus a four-stage teaching technique. Laypersons were randomized to either two-stage or four-stage teaching technique courses. Immediately after training, the participants were tested in a simulated cardiac arrest scenario to assess their BLS/AED skills. Skills were assessed using the European Resuscitation Council BLS/AED assessment form. The primary endpoint was passing the test (17 of 17 skills adequately performed). A prespecified noninferiority margin of 20% was used. The two-stage teaching technique (n=72, pass rate 57%) was noninferior to the four-stage technique (n=70, pass rate 59%), with a difference in pass rates of -2%; 95% confidence interval: -18 to 15%. Neither were there significant differences between the two-stage and four-stage groups in the chest compression rate (114±12 vs. 115±14/min), chest compression depth (47±9 vs. 48±9 mm) and number of sufficient rescue breaths between compression cycles (1.7±0.5 vs. 1.6±0.7). In both groups, all participants believed that their training had improved their skills. Teaching laypersons BLS/AED using the two-stage teaching technique was noninferior to the four-stage teaching technique, although the pass rate was -2% (95% confidence interval: -18 to 15%) lower with the two-stage teaching technique.

Stage line diagram: an age-conditional reference diagram for tracking development.

Science.gov (United States)

van Buuren, Stef; Ooms, Jeroen C L

2009-05-15

This paper presents a method for calculating stage line diagrams, a novel type of reference diagram useful for tracking developmental processes over time. Potential fields of applications include: dentistry (tooth eruption), oncology (tumor grading, cancer staging), virology (HIV infection and disease staging), psychology (stages of cognitive development), human development (pubertal stages) and chronic diseases (stages of dementia). Transition probabilities between successive stages are modeled as smoothly varying functions of age. Age-conditional references are calculated from the modeled probabilities by the mid-P value. It is possible to eliminate the influence of age by calculating standard deviation scores (SDS). The method is applied to the empirical data to produce reference charts on secondary sexual maturation. The mean of the empirical SDS in the reference population is close to zero, whereas the variance depends on age. The stage line diagram provides quick insight into both status (in SDS) and tempo (in SDS/year) of development of an individual child. Other measures (e.g. height SDS, body mass index SDS) from the same child can be added to the chart. Diagrams for sexual maturation are available as a web application at http://vps.stefvanbuuren.nl/puberty. The stage line diagram expresses status and tempo of discrete changes on a continuous scale. Wider application of these measures scores opens up new analytic possibilities. (c) 2009 John Wiley & Sons, Ltd.

Compliance and control characteristics of an additive manufactured-flexure stage

Energy Technology Data Exchange (ETDEWEB)

Lee, ChaBum; Tarbutton, Joshua A. [Department of Mechanical Engineering, University of South Carolina, 300 Main St., Columbia, South Carolina 29208 (United States)

2015-04-15

This paper presents a compliance and positioning control characteristics of additive manufactured-nanopositioning system consisted of the flexure mechanism and voice coil motor (VCM). The double compound notch type flexure stage was designed to utilize the elastic deformation of two symmetrical four-bar mechanisms to provide a millimeter-level working range. Additive manufacturing (AM) process, stereolithography, was used to fabricate the flexure stage. The AM stage was inspected by using 3D X-ray computerized tomography scanner: air-voids and shape irregularity. The compliance, open-loop resonance peak, and damping ratio of the AM stage were measured 0.317 mm/N, 80 Hz, and 0.19, respectively. The AM stage was proportional-integral-derivative positioning feedback-controlled and the capacitive type sensor was used to measure the displacement. As a result, the AM flexure mechanism was successfully 25 nm positioning controlled within 500 μm range. The resonance peak was found approximately at 280 Hz in closed-loop. This research showed that the AM flexure mechanism and the VCM can provide millimeter range with high precision and can be a good alternative to an expensive metal-based flexure mechanism and piezoelectric transducer.

Compliance and control characteristics of an additive manufactured-flexure stage

International Nuclear Information System (INIS)

Lee, ChaBum; Tarbutton, Joshua A.

2015-01-01

This paper presents a compliance and positioning control characteristics of additive manufactured-nanopositioning system consisted of the flexure mechanism and voice coil motor (VCM). The double compound notch type flexure stage was designed to utilize the elastic deformation of two symmetrical four-bar mechanisms to provide a millimeter-level working range. Additive manufacturing (AM) process, stereolithography, was used to fabricate the flexure stage. The AM stage was inspected by using 3D X-ray computerized tomography scanner: air-voids and shape irregularity. The compliance, open-loop resonance peak, and damping ratio of the AM stage were measured 0.317 mm/N, 80 Hz, and 0.19, respectively. The AM stage was proportional-integral-derivative positioning feedback-controlled and the capacitive type sensor was used to measure the displacement. As a result, the AM flexure mechanism was successfully 25 nm positioning controlled within 500 μm range. The resonance peak was found approximately at 280 Hz in closed-loop. This research showed that the AM flexure mechanism and the VCM can provide millimeter range with high precision and can be a good alternative to an expensive metal-based flexure mechanism and piezoelectric transducer

Stage design

International Nuclear Information System (INIS)

Shacter, J.

1975-01-01

A method is described of cycling gases through a plurality of diffusion stages comprising the steps of admitting the diffused gases from a first diffusion stage into an axial compressor, simultaneously admitting the undiffused gases from a second diffusion stage into an intermediate pressure zone of said compressor corresponding in pressure to the pressure of said undiffused gases, and then admitting the resulting compressed mixture of diffused and undiffused gases into a third diffusion stage

Experimental Results of the First Two Stages of an Advanced Transonic Core Compressor Under Isolated and Multi-Stage Conditions

Science.gov (United States)

Prahst, Patricia S.; Kulkarni, Sameer; Sohn, Ki H.

2015-01-01

NASA's Environmentally Responsible Aviation (ERA) Program calls for investigation of the technology barriers associated with improved fuel efficiency of large gas turbine engines. Under ERA the task for a High Pressure Ratio Core Technology program calls for a higher overall pressure ratio of 60 to 70. This mean that the HPC would have to almost double in pressure ratio and keep its high level of efficiency. The challenge is how to match the corrected mass flow rate of the front two supersonic high reaction and high corrected tip speed stages with a total pressure ratio of 3.5. NASA and GE teamed to address this challenge by using the initial geometry of an advanced GE compressor design to meet the requirements of the first 2 stages of the very high pressure ratio core compressor. The rig was configured to run as a 2 stage machine, with Strut and IGV, Rotor 1 and Stator 1 run as independent tests which were then followed by adding the second stage. The goal is to fully understand the stage performances under isolated and multi-stage conditions and fully understand any differences and provide a detailed aerodynamic data set for CFD validation. Full use was made of steady and unsteady measurement methods to isolate fluid dynamics loss source mechanisms due to interaction and endwalls. The paper will present the description of the compressor test article, its predicted performance and operability, and the experimental results for both the single stage and two stage configurations. We focus the detailed measurements on 97 and 100 of design speed at 3 vane setting angles.

Evaluation of an Internet, Stage-Based Physical Activity Intervention.

Science.gov (United States)

Hager, Ronald L.; Hardy, Aaron; Aldana, Steven G.; George, James D.

2002-01-01

Evaluated the impact of online, stage-based materials on exercise behavior and stage of readiness to change. College faculty participated in stage-based, action-message, or control groups. Occupational and leisure activity, 7-day physical activity, exercise self-efficacy, and stage of readiness to change were assessed at baseline and 6 weeks.…

SPIRIT advance care planning intervention in early stage dementias: An NIH stage I behavioral intervention development trial.

Science.gov (United States)

Song, Mi-Kyung; Ward, Sandra E; Hepburn, Kenneth; Paul, Sudeshna; Shah, Raj C; Morhardt, Darby J

2018-06-02

People in the early stages of Alzheimer's disease and related dementias (ADRD) are encouraged to engage in advance care planning (ACP) while they are still competent to appoint a surrogate decision maker and meaningfully participate in ACP discussions with the surrogate. In this NIH Stage I behavioral intervention development trial, we will adapt and test an efficacious ACP intervention, SPIRIT (Sharing Patient's Illness Representation to Increase Trust), with people with mild dementia and their surrogates to promote open, honest discussions while such discussions about end-of-life care are possible. We will first adapt SPIRIT (in person) to target people with mild dementia and their surrogates through a process of modification-pretesting-refinement using stakeholders (persons with mild dementia, family caregivers, and clinicians) and experts, including adapting the delivery mode to interactive web-based videoconference format (SPIRIT-remote). Then in a 3-group RCT with 120 patient-surrogate dyads, we will evaluate the feasibility and acceptability of SPIRIT in-person and SPIRIT remote, and preliminary efficacy of SPIRIT compared to usual care on preparedness outcomes for end-of-life decision making (dyad congruence on goals of care, patient decisional conflict, and surrogate decision-making confidence) shortly after the intervention. This Stage I research of SPIRIT will generate valuable insights regarding how to improve ACP for people with mild dementia who will progress to an advanced stage of the disease in the foreseeable future. ClinicalTrials.gov NCT03311711, Registered 10/12/2017. Copyright © 2018. Published by Elsevier Inc.

Predictors of cervical cancer being at an advanced stage at diagnosis in Sudan

DEFF Research Database (Denmark)

Ibrahim, Ahmed; Rasch, Vibeke; Pukkala, Eero

2011-01-01

Cervical cancer is the second most common cancer among women in Sudan, with more than two-thirds of all women with invasive cervical cancer being diagnosed at an advanced stage (stages III and IV). The lack of a screening program for cervical cancer in Sudan may contribute to the late presentation...... of this cancer, but other factors potentially associated with advanced stages of cervical cancer at diagnosis are unknown. The purpose of this research was to investigate the relationship between age, marital status, ethnicity, health insurance coverage, residence in an urban vs a rural setting, and stage (at...... diagnosis) of cervical cancer in Sudan....

Design of an Image-Servo Mask Alignment System Using Dual CCDs with an XXY Stage

Directory of Open Access Journals (Sweden)

Chih-Jer Lin

2016-02-01

Full Text Available Mask alignment of photolithography technology is used in many applications, such as micro electro mechanical systems’ semiconductor process, printed circuits board, and flat panel display. As the dimensions of the product are getting smaller and smaller, the automatic mask alignment of photolithography is becoming more and more important. The traditional stacked XY-Θz stage is heavy and it has cumulative flatness errors due to its stacked assembly mechanism. The XXY stage has smaller cumulative error due to its coplanar design and it can move faster than the traditional XY-Θz stage. However, the relationship between the XXY stage’s movement and the commands of the three motors is difficult to compute, because the movements of the three motors on the same plane are coupling. Therefore, an artificial neural network is studied to establish a nonlinear mapping from the desired position and orientation of the stage to three motors’ commands. Further, this paper proposes an image-servo automatic mask alignment system, which consists of a coplanar XXY stage, dual GIGA-E CCDs with lens and a programmable automatic controller (PAC. Before preforming the compensation, a self-developed visual-servo provides the positioning information which is obtained from the image processing and pattern recognition according to the specified fiducial marks. To obtain better precision, two methods including the center of gravity method and the generalize Hough Transformation are studied to correct the shift positioning error.

An adaptive two-stage dose-response design method for establishing proof of concept.

Science.gov (United States)

Franchetti, Yoko; Anderson, Stewart J; Sampson, Allan R

2013-01-01

We propose an adaptive two-stage dose-response design where a prespecified adaptation rule is used to add and/or drop treatment arms between the stages. We extend the multiple comparison procedures-modeling (MCP-Mod) approach into a two-stage design. In each stage, we use the same set of candidate dose-response models and test for a dose-response relationship or proof of concept (PoC) via model-associated statistics. The stage-wise test results are then combined to establish "global" PoC using a conditional error function. Our simulation studies showed good and more robust power in our design method compared to conventional and fixed designs.

An analysis of the Athetis lepigone transcriptome from four developmental stages.

Directory of Open Access Journals (Sweden)

Li-Tao Li

Full Text Available Athetis lepigone Möschler (Lepidoptera: Noctuidae has recently become an important insect pest of maize (Zea mays crops in China. In order to understand the characteristics of the different developmental stages of this pest, we used Illumina short-read sequences to perform de novo transcriptome assembly and gene expression analysis for egg, larva, pupa and adult developmental stages. We obtained 10.08 Gb of raw data from Illumina sequencing and recovered 81,356 unigenes longer than 100 bp through a de novo assembly. The total sequence length reached 49.75 Mb with 858 bp of N50 and an average unigene length of 612 bp. Annotation analysis of predicted proteins indicate that 33,736 unigenes (41.47% of total unigenes are matches to genes in the Genbank Nr database. The unigene sequences were subjected to GO, COG and KEGG functional classification. A large number of differentially expressed genes were recovered by pairwise comparison of the four developmental stages. The most dramatic differences in gene expression were found in the transitions from one stage to another stage. Some of these differentially expressed genes are related to cuticle and wing formation as well as the growth and development. We identified more than 2,500 microsatellite markers that may be used for population studies of A. lepigone. This study lays the foundation for further research on population genetics and gene function analysis in A. lepigone.

Evaluation of a Gentex (registered trademark) ORO-NASAL Oxygen Mask for Integration with the Aqualung (registered trademark) Personal Helicopter Oxygen Delivery System (PHODS)

National Research Council Canada - National Science Library

Roller, Richard A; Curry, Ian P

2008-01-01

.... The United States Army Aeromedical Research Laboratory (USAARL) was tasked by the Product Manager Air Warrior to evaluate an oxygen mask for use with the Personal Helicopter Oxygen Delivery System (PHODS...

Safe Ride Standards for Casualty Evacuation Using Unmanned Aerial Vehicles (Normes de transport sans danger pour l’evacuation des blesses par vehicules aeriens sans pilote)

Science.gov (United States)

2012-12-01

September 2008. 11.2 CLINICAL AND OPERATIONAL DOCUMENTS Aerospace Medical Association Air Transport Committee, “Medical Guidelines for Airline ...RTO-MP-HFM-157////MP-HFM-157-19.doc. Turner, S., Ruth, M.J. and Bruce, D.L., “In Flight Catering : Feeding Critical Care Patients During Aeromedical...feet. 8 Turner, S., Ruth, M.J. and Bruce, D.L. “In flight catering : Feeding critical care patients during aeromedical evacuation”. 9 Renz, E.M

Index to FAA Office of Aviation Medicine reports : 1961 through 1973.

Science.gov (United States)

1974-03-01

An index to Office of Aviation Medicine Reports (1964-1973) and Civil Aeromedical Research Institute Reports (1961-1963) is presented as a quick reference for those engaged in aviation medicine and related activities.

Dynamic Modeling of Starting Aerodynamics and Stage Matching in an Axi-Centrifugal Compressor

Science.gov (United States)

Wilkes, Kevin; OBrien, Walter F.; Owen, A. Karl

1996-01-01

A DYNamic Turbine Engine Compressor Code (DYNTECC) has been modified to model speed transients from 0-100% of compressor design speed. The impetus for this enhancement was to investigate stage matching and stalling behavior during a start sequence as compared to rotating stall events above ground idle. The model can simulate speed and throttle excursions simultaneously as well as time varying bleed flow schedules. Results of a start simulation are presented and compared to experimental data obtained from an axi-centrifugal turboshaft engine and companion compressor rig. Stage by stage comparisons reveal the front stages to be operating in or near rotating stall through most of the start sequence. The model matches the starting operating line quite well in the forward stages with deviations appearing in the rearward stages near the start bleed. Overall, the performance of the model is very promising and adds significantly to the dynamic simulation capabilities of DYNTECC.

Stages of use: consideration, initiation, utilization, and outcomes of an internet-mediated intervention

Directory of Open Access Journals (Sweden)

Eysenbach Gunther

2010-11-01

Full Text Available Abstract Background Attrition, or nonuse of the intervention, is a significant problem in e-health. However, the reasons for this phenomenon are poorly understood. Building on Eysenbach's "Law of Attrition", this study aimed to explore the usage behavior of users of e-health services. We used two theoretical models, Andersen's Behavioral Model of Health Service Utilization and Venkatesh's Unified Theory of Acceptance and Use of Technology, to explore the factors associated with uptake and use of an internet-mediated intervention for caregivers taking care of a family member with dementia. Methods A multiphase, longitudinal design was used to follow a convenience sample of 46 family caregivers who received an e-health intervention. Applying the two theories, usage behavior was conceptualized to form four stages: consideration, initiation, utilization (attrition or continuation, and outcome. The variables and measurement scales were selected based on these theories to measure the sociodemographic context, technology aptitudes, and clinical needs of the caregivers. Results In the Consideration Stage, caregivers who felt that the information communication technology (ICT-mediated service was easy to use were more likely to consider participating in the study (p = 0.04. In the Initiation Stage, caregivers who showed greater technology acceptance were more likely to initiate service earlier (p = 0.02. In the Utilization Stage, the frequent users were those who had a more positive attitude toward technology (p = 0.04 and a lower perceived caregiver competence (p = 0.04 compared with nonusers. In the Outcome Stage, frequent users experienced a decline in perceived burden compared with an escalation of perceived burden by nonusers (p = 0.02. Conclusions We illustrate a methodological framework describing how to develop and expand a theory on attrition. The proposed framework highlighted the importance of conceptualizing e-health "use" and "adoption" as

Multi-stage autoacceleration of an intense relativistic electron beam

Energy Technology Data Exchange (ETDEWEB)

Kamada, K; Hasegawa, D; Igarashi, H; Kusunoki, T; Lee, C Y; Koguchi, H; Ando, R; Masuzaki, M [Kanazawa Univ. (Japan). Department of Physics

1997-12-31

Two-stage autoacceleration was accomplished by using different length cavities. Two cavities were located with the distance longer than the beam duration. The electron kinetic energy increased from 500 to 700 keV at the first stage and from 700 to 900 keV at the second, while the beam duration decreased 10 to 5 ns at the first stage and 5 to 2.5 ns at the second. (author). 7 figs., 7 refs.

Initiation of an early-stage plasma during picosecond laser ablation of solids

International Nuclear Information System (INIS)

Mao, Samuel S.; Mao, Xianglei; Greif, Ralph; Russo, Richard E.

2000-01-01

Picosecond time-resolved images of plasma initiation were recorded during pulsed-laser ablation of metal targets in an air atmosphere. An early-stage plasma was observed to form before the release of a material vapor plume. Close to the target surface, interferometry measurements indicate that the early-stage plasma has an electron number density on the order of 10 20 cm -3 . The longitudinal expansion of the ionization front for this plasma has a velocity 10 9 cm/s, during the laser pulse. In contrast, a material--vapor plume forms approximately 200 ps after the laser pulse, and it moves away from the target at 10 6 cm/s. The experimental observations of the early-stage plasma were simulated by using a theoretical model based on a two-fluids description of laser plasmas. The results indicate that the initiation of the plasma is due to air breakdown assisted by electron emission from the target

Novel clinical staging for patients with end-stage gastrointestinal carcinoma.

Science.gov (United States)

Yasuda, Naokuni; Nakashima, Osamu; Ohnaka, Toru; Kamisaka, Koji; Tsunoda, Akira; Kusano, Mitsuo

2006-01-01

We created a new clinical staging system for end-stage gastrointestinal (GI) carcinoma to clarify the therapeutic goals for these patients. Data were obtained from a retrospective review of medical charts. Based on daily clinical observation of 144 patients with end-stage GI carcinoma, we classified the terminal stages as A, B, C, and D. The mean durations of terminal stages A, B, C, and D were 19, 16.6, 6.6, and 1.8 days, respectively, in patients with end-stage gastric cancer and 28.5, 9.1, 5.4, and 1.9 days, respectively, in patients with colorectal cancer. Moreover, 88.0% of patients with gastric carcinoma and 82.6% of patients with colorectal carcinoma passed through terminal stages A, B, C, and D sequentially. The patients in terminal stage B experienced temporary relief of symptoms, but those in terminal stage C did not (P terminal stages can easily be judged by clinical observation and may be an effective new tool with which to manage patients with end-stage GI carcinoma and their families.

MR staging accuracy for endometrial cancer based on the new FIGO stage

International Nuclear Information System (INIS)

Shin, Kyung Eun; Park, Byung Kwan; Kim, Chan Kyo; Bae, Duk Soo; Song, Sang Yong; Kim, Bohyun

2011-01-01

Background: Magnetic resonance imaging (MRI) has been frequently used to determine a preoperative treatment plan for gynecologic cancers. However, the MR accuracy for staging an endometrial cancer is not satisfactory based on the old FIGO staging system. Purpose: To evaluate MR accuracy for staging endometrial cancer using the new FIGO staging system. Material and Methods: Between January 2005 and May 2009, 199 women underwent surgery due to endometrial cancer. In each patient, an endometrial cancer was staged using MR findings based on the old FIGO staging system and then repeated according to the new FIGO staging system for comparison. Histopathologic findings were used as a standard of reference. Results: The accuracy of MRI in the staging of endometrial carcinoma stage I, II, III, and IV using the old FIGO staging system were 80% (159/199), 89% (178/199), 90% (179/199), and 99% (198/199), respectively, compared to 87% (174/199), 97% (193/199), 90% (179/199), and 99% (198/199), respectively, when using the new FIGO staging criteria. The overall MR accuracy of the old and new staging systems were 51% (101/199) and 81% (161/199), respectively. Conclusion: MRI has become a more useful tool in the preoperative staging of endometrial cancers using the new FIGO staging system compared to the old one with increased accuracy

An image-based automatic recognition method for the flowering stage of maize

Science.gov (United States)

Yu, Zhenghong; Zhou, Huabing; Li, Cuina

2018-03-01

In this paper, we proposed an image-based approach for automatic recognizing the flowering stage of maize. A modified HOG/SVM detection framework is first adopted to detect the ears of maize. Then, we use low-rank matrix recovery technology to precisely extract the ears at pixel level. At last, a new feature called color gradient histogram, as an indicator, is proposed to determine the flowering stage. Comparing experiment has been carried out to testify the validity of our method and the results indicate that our method can meet the demand for practical observation.

Multiple stage railgun

International Nuclear Information System (INIS)

Aaland, K.; Hawke, R.S.; Scudder, J.K.

1982-01-01

A multiple stage magnetic railgun accelerator for accelerating a projectile by movement of a plasma arc along the rails. The railgun is divided into a plurality of successive rail stages which are sequentially energized by separate energy sources as the projectile moves through the bore of the railgun. Propagation of energy from an energized rail stage back towards the breech end of the railgun can be prevented by connection of the energy sources to the rails through isolation diodes. Propagation of energy from an energized rail stage back towards the breech end of the railgun can also be prevented by dividing the rails into electrically isolated rail sections. In such case means are used to extinguish the arc at the end of each energized stage and a fuse or laser device is used to initiate a new plasma arc in the next energized rail stage

An Enhanced Preventive Maintenance Optimization Model Based on a Three-Stage Failure Process

Directory of Open Access Journals (Sweden)

Ruifeng Yang

2015-01-01

Full Text Available Nuclear power plants are highly complex systems and the issues related to their safety are of primary importance. Probabilistic safety assessment is regarded as the most widespread methodology for studying the safety of nuclear power plants. As maintenance is one of the most important factors for affecting the reliability and safety, an enhanced preventive maintenance optimization model based on a three-stage failure process is proposed. Preventive maintenance is still a dominant maintenance policy due to its easy implementation. In order to correspond to the three-color scheme commonly used in practice, the lifetime of system before failure is divided into three stages, namely, normal, minor defective, and severe defective stages. When the minor defective stage is identified, two measures are considered for comparison: one is that halving the inspection interval only when the minor defective stage is identified at the first time; the other one is that if only identifying the minor defective stage, the subsequent inspection interval is halved. Maintenance is implemented immediately once the severe defective stage is identified. Minimizing the expected cost per unit time is our objective function to optimize the inspection interval. Finally, a numerical example is presented to illustrate the effectiveness of the proposed models.

Index to FAA Office of Aviation Medicine reports : 1961 through 2000.

Science.gov (United States)

2001-01-01

An index to Federal Aviation Administration Office of Aviation Medicine Reports (1964-2000), : CARI Reports (1961-1963), and Civil Aeromedical Institute Reports is presented for those : engaged in aviation medicine and related activities. The index l...

Shape oscillations of microparticles on an optical microscope stage.

Science.gov (United States)

Zhu, Z M; Apfel, R E

1985-11-01

A modulated acoustic radiation pressure technique to produce quadrupole shape oscillations of drops ranging in diameter from 50-220 micron has been used by us. These drops have been suspended by acoustic levitation in a small chamber mounted on a stage of an optical microscope, which allowed easy viewing. The fission of drops and the deformation of sea urchin eggs were also observed.

Changes in blood flow during one stage lengthening of bone: an experimental study in rats.

Science.gov (United States)

Kwon, S T; Chung, C Y

2000-06-01

Distraction osteogenesis is a well-accepted method of bone lengthening. Its disadvantages, however, are that it requires an external fixator and takes a long time. One-stage lengthening therefore offers certain advantages. A first point of reference for the safe limits of this procedure might be the changes of blood flow, and this is also the crucial factor in deciding on the appropriate method of lengthening, particularly where the hand or foot is involved. Using a laser Doppler flowmeter we measured blood flow in the dorsum of the foot after using bilateral minimonofixators to lengthen the tibias of 15 Sprague-Dawley rats. They were lengthened in four stages: stage 0 (before lengthening); stage I--12.5%; stage II--25%; and stage III--31.25% of lengthening. The blood flow during stage I decreased to 79% compared to that of stage 0; 16% during stage II; and 1% during stage III. This study suggests that the maximal permissible extent of lengthening might be less than a quarter according to the blood flow as suggested by this animal model.

Standard of care of erectile dysfunction in U.S. Air Force aircrew and active duty not on flying status.

Science.gov (United States)

Nast, Justin B

2014-11-01

In 2011, over 3,000 active duty U.S. Air Force (USAF) members were prescribed a phosphodiesterase inhibitor (PDEI). PDEIs are first-line therapy for treating erectile dysfunction and can have significant side effects that could impact aircrew performance. In total, 200 eligible subject records were randomly sampled from the active duty USAF population of those males filling a prescription for a PDEI in June 2011; 100 of those records were from aviators. The electronic records were reviewed and scored to determine if USAF aeromedical standards for prescribing PDEIs were followed, with a minimum score of 0 for no standards met and a maximum of 3 for all standards met. The average score for both groups was 1, with no significant difference between the group scores. A proper aeromedical disposition was documented in 67% of the aviator records. Although there was no significant difference in standard of care for aviators and nonaviators, the overall documented standard of care was poor. Lack of documentation was the primary reason for the low scores and the low percentage of properly rendered aeromedical dispositions. Proper medical record documentation is important for evaluating quality of care and ensuring compliance with regulations in an Air Force aviator population. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Index to FAA Office of Aerospace Medicine Reports : 1961 Through 2006

Science.gov (United States)

2007-01-01

An index to Federal Aviation Administration Office of Aerospace Medicine Reports (1964-2006) and Civil : Aeromedical Institute Reports (1961-1963) is presented for those engaged in aviation medicine and related : activities. The index lists all FAA a...

Index to FAA Office of Aerospace Medicine reports : 1961 through 2002.

Science.gov (United States)

2003-01-01

An index to Federal Aviation Administration Office of Aerospace Medicine Reports (1964-2002) : and Civil Aeromedical Institute Reports (1961-1963) is presented for those engaged in aviation : medicine and related activities. The index lists all FAA A...

Index to FAA Office of Aviation Medicine reports : 1961 through 1998.

Science.gov (United States)

1999-01-01

An index to Office of Aviation Medicine Reports (1964-1998) and Civil Aeromedical Research Institute Reports is presented for those engaged in aviation medicine and related activities. The index lists all FAA aviation medicine reports published from ...

Index to FAA Office of Aerospace Medicine reports : 1961 through 2004.

Science.gov (United States)

2005-01-01

An index to Federal Aviation Administration Office of Aerospace Medicine Reports (1964-2004) and : Civil Aeromedical Institute Reports (1961-1963) is presented for those engaged in aviation medicine and : related activities. The index lists all FAA a...

Index to FAA Office of Aviation Medicine reports : 1961 through 1995.

Science.gov (United States)

1996-01-01

An index to Federal Aviation Administration (FAA) Office of Aviation Medicine Reports (1964-1995) and Civil Aeromedical Institute Reports is presented for those engaged in aviation medicine and related activities. The index lists all FAA aviation med...

Index to FAA Office of Aviation Medicine reports : 1961 through 1999.

Science.gov (United States)

2000-01-01

An index to Federal Aviation Administration Office of Aviation Medicine Reports (1964-1999) and : Civil Aeromedical Institute Reports (1961-1963) is presented for those engaged in aviation medicine : and related activities. The index lists all FAA av...

Index to FAA Office of Aerospace Medicine reports : 1961 through 2008.

Science.gov (United States)

2009-01-01

An index to Federal Aviation Administration Office of Aerospace Medicine Reports (1964-2008) and Civil : Aeromedical Institute Reports (1961-1963) is presented for those engaged in aviation medicine and related : activities. The index lists all FAA a...

A simplified staging system based on the radiological findings in different stages of ochronotic spondyloarthropathy

International Nuclear Information System (INIS)

Jebaraj, Isaac; Chacko, Binita Riya; Chiramel, George Koshy; Matthai, Thomas; Parameswaran, Apurve

2013-01-01

This study describes a group of 26 patients with ochronotic spondyloarthropathy who were on regular treatment and follow-up at a tertiary level hospital and proposes a simplified staging system for ochronotic spondyloarthropathy based on radiographic findings seen in the thoracolumbar spine. This proposed classification makes it easy to identify the stage of the disease and start the appropriate management at an early stage. Four progressive stages are described: an inflammatory stage (stage 1), the stage of early discal calcification (stage 2), the stage of fibrous ankylosis (stage 3), and the stage of bony ankylosis (stage 4). To our knowledge, this is the largest reported series of radiological description of spinal ochronosis, and emphasizes the contribution of the spine radiograph in the diagnosis and staging of the disease

A simplified staging system based on the radiological findings in different stages of ochronotic spondyloarthropathy

Directory of Open Access Journals (Sweden)

Isaac Jebaraj

2013-01-01

Full Text Available This study describes a group of 26 patients with ochronotic spondyloarthropathy who were on regular treatment and follow-up at a tertiary level hospital and proposes a simplified staging system for ochronotic spondyloarthropathy based on radiographic findings seen in the thoracolumbar spine. This proposed classification makes it easy to identify the stage of the disease and start the appropriate management at an early stage. Four progressive stages are described: an inflammatory stage (stage 1, the stage of early discal calcification (stage 2, the stage of fibrous ankylosis (stage 3, and the stage of bony ankylosis (stage 4. To our knowledge, this is the largest reported series of radiological description of spinal ochronosis, and emphasizes the contribution of the spine radiograph in the diagnosis and staging of the disease.

Vaginal cancer, an analysis of stages 1 and 2

International Nuclear Information System (INIS)

Dickie, G.J.; Tripcony, L.; Otten, G.; Nicklin, J.

2003-01-01

A retrospective analysis was performed of 70 patients with stages 1 and 2 vaginal cancer seen between 1982 and 1998 at the Royal Brisbane and Royal Women's Hospitals, Queensland. Forty three patients had previously had a hysterectomy. Stage, histology and grade were the most important prognostic factors. The 5 year survival rate for stage 1 was 71%, compared to 48% for stage 2. The majority (61 patients) had squamous cell carcinoma with a 68% survival compared to 22% for adenocarcinoma. Those with histological grade 1 and 2 had a 69% survival compared to 40% for grade 3 disease. Age, whether the patient had a previous hysterectomy, tumour site and size were not significant prognostic factors. The majority of patients were treated with radiotherapy alone. However those that had surgery alone or surgery combined with radiotherapy had a significantly improved survival compared to the radiotherapy alone group. The majority of tumours recurred in the loco-regional area and the median time to recurrence was 12 months

PARTIAL SPLENECTOMY IN CHILDREN - AN ALTERNATIVE FOR SPLENECTOMY IN THE PATHOLOGICAL STAGING OF HODGKINS-DISEASE

NARCIS (Netherlands)

HOEKSTRA, HJ; TAMMINGA, RYJ; TIMENS, W

1994-01-01

Background: The more accurate staging of Hodgkin's disease in children is achieved with a staging laparotomy and splenectomy. A disadvantage of the splenectomy is the high risk for an overwhelming postsplenectomy sepsis (OPSI). Therefore, the partial splenectomy was introduced as an alternative to

An Effective Technique for Endoscopic Resection of Advanced Stage Angiofibroma

Science.gov (United States)

Mohammadi Ardehali, Mojtaba; Samimi, Seyyed Hadi; Bakhshaee, Mehdi

2014-01-01

Introduction: In recent years, the surgical management of angiofibroma has been greatly influenced by the use of endoscopic techniques. However, large tumors that extend into difficult anatomic sites present major challenges for management by either endoscopy or an open-surgery approach which needs new technique for the complete en block resection. Materials and Methods: In a prospective observational study we developed an endoscopic transnasal technique for the resection of angiofibroma via pushing and pulling the mass with 1/100000 soaked adrenalin tampons. Thirty two patients were treated using this endoscopic technique over 7 years. The mean follow-up period was 36 months. The main outcomes measured were tumor staging, average blood loss, complications, length of hospitalization, and residual and/or recurrence rate of the tumor. Results: According to the Radkowski staging, 23,5, and 4 patients were at stage IIC, IIIA, and IIIB, respectively. Twenty five patients were operated on exclusively via transnasal endoscopy while 7 patients were managed using endoscopy-assisted open-surgery techniques. Mean blood loss in patients was 1261± 893 cc. The recurrence rate was 21.88% (7 cases) at two years following surgery. Mean hospitalization time was 3.56 ± 0.6 days. Conclusion: Using this effective technique, endoscopic removal of more highly advanced angiofibroma is possible. Better visualization, less intraoperative blood loss, lower rates of complication and recurrence, and shorter hospitalization time are some of the advantages. PMID:24505571

An Effective Technique for Endoscopic Resection of Advanced Stage Angiofibroma

Directory of Open Access Journals (Sweden)

Mojtaba Mohammadi Ardehali

2014-01-01

Full Text Available Introduction: In recent years, the surgical management of angiofibroma has been greatly influenced by the use of endoscopic techniques. However, large tumors that extend into difficult anatomic sites present major challenges for management by either endoscopy or an open-surgery approach which needs new technique for the complete en block resection.   Materials and Methods: In a prospective observational study we developed an endoscopic transnasal technique for the resection of angiofibroma via pushing and pulling the mass with 1/100000 soaked adrenalin tampons. Thirty two patients were treated using this endoscopic technique over 7 years. The mean follow-up period was 36 months. The main outcomes measured were tumor staging, average blood loss, complications, length of hospitalization, and residual and/or recurrence rate of the tumor.   Results: According to the Radkowski staging, 23,5, and 4 patients were at stage IIC, IIIA, and IIIB, respectively. Twenty five patients were operated on exclusively via transnasal endoscopy while 7 patients were managed using endoscopy-assisted open-surgery techniques. Mean blood loss in patients was 1261± 893 cc. The recurrence rate was 21.88% (7 cases at two years following surgery. Mean hospitalization time was 3.56 ± 0.6 days.   Conclusion:  Using this effective technique, endoscopic removal of more highly advanced angiofibroma is possible. Better visualization, less intraoperative blood loss, lower rates of complication and recurrence, and shorter hospitalization time are some of the advantages.

Index to FAA Office of Aviation Medicine reports : 1961 through 1996.

Science.gov (United States)

1997-01-01

An index to Office of Aviation Medicine Reports (1964-1996) and Civil Aeromedical Research Institute Reports is presented as a reference for those engaged in aviation medicine and related activities. The index lists all FAA aviation medicine reports ...

Index to FAA Office of Aviation Medicine reports : 1961 through 1993.

Science.gov (United States)

1994-01-01

An index to Office of Aviation Medicine Reports (1964-1993) and Civil Aeromedical Research Institute Reports is presented as a reference for those engaged in aviation medicine and related activities. It lists all FAA aviation medicine reports publish...

Evaluation of functional color vision requirements and current color vision screening tests for air traffic control specialists.

Science.gov (United States)

1990-08-01

An experiment was conducted to evaluate the relation of type and degree of color vision deficiency and aeromedical color vision screening test scores to performance of color-dependent tasks of Air Traffic Control Specialists. The subjects included 37...

Design and Analysis of an Abbé Free Coplanar Stage

Directory of Open Access Journals (Sweden)

Chung Tien-Tung

2017-01-01

Full Text Available Design and analysis of a new Abbé free coplanar xy stage are presented in this paper. The xy stage is formed as conventional xy stages which combine with two stacked up linear guides. The x-guide is on the bottom and the y-guide is on top of the x-guide. The travel range of this xy stage is 300mm × 300mm, which fits dimensions of 12-inch wafers. A special mechanism is designed such that the z-surface of the y-guide has the same height as the z-surface of x-guide, and the Abbé error and cumulative error of this coplanar stage can be reduced. The concept of symmetric structure design is also considered to eliminate the structural deformation due to driving force of two guides. For this long travel range precision stage, the finite element method (FEM is applied to analyze the structural deformation and vibration natural frequencies. The requirement of structural deformation due to self-weight load is limited to 1.5μm, and first natural frequency is limited to over 100 Hz.

Development of an international schedule for the assessment and staging of care for dementia

NARCIS (Netherlands)

Semrau, M.; Burns, A.; Djukic-Dejanovic, S.; Eraslan, D.; Han, C.; Lecic-Tosevski, D.; Lobo, A.; Mihai, A.; Morris, J.; Palumbo, C.; Robert, P.; Stiens, G.; Stoppe, G.; Volpe, U.; Olde Rikkert, M.G.M.; Sartorius, N.

2015-01-01

BACKGROUND: A reliable and valid global staging scale has been lacking within dementia care. OBJECTIVE: To develop an easy-to-use multi-dimensional clinical staging schedule for dementia. METHODS: The schedule was developed through: i) Two series of focus groups (40 and 48 participants,

Effects of an Interdisciplinary Practice Bundle for Second-Stage Labor on Clinical Outcomes.

Science.gov (United States)

Garpiel, Susan J

2018-04-09

There is renewed interest in second-stage labor practices as recent evidence has challenged historical perspectives on safe duration of secondstage labor. Traditional practices and routine interventions during second-stage have uncertain benefit for low-risk women and may result in cesarean birth. The purpose of this quality improvement project was to implement an interdisciplinary second-stage practice bundle to promote safe outcomes including method of birth and women's birth experience. Standardized second-stage labor evidence-based practice recommendations structured into a 5 Ps practice bundle (patience, positioning, physiologic resuscitation, progress, preventing urinary harm) were implemented across 34 birthing hospitals in Trinity Health system. Significant improvements were observed in second-stage practices. Association of Women's Health, Obstetric and Neonatal Nurses' perinatal nursing care quality measure Second-Stage of Labor: Mother-Initiated Spontaneous Pushing significantly improved [pre-implementation 43% (510/1,195), post-implementation 76% (1,541/2,028), p labor practices derived from the Association of Women's Health, Obstetric and Neonatal Nurses and American College of Nurse-Midwives professional guidelines achieved our goals of safely reducing primary cesarean birth among low-risk nulliparous women, and optimizing maternal and fetal outcomes associated with labor and birth. By minimizing routine interventions, nurses support physiologic birth and improve women's birth satisfaction.

Model of unplanned smoking initiation of children and adolescents: an integrated stage model of smoking behavior.

Science.gov (United States)

Kremers, S P J; Mudde, A N; De Vries, H

2004-05-01

Two lines of psychological research have attempted to spell out the stages of adolescent smoking initiation. The first has focused on behavioral stages of smoking initiation, while the second line emphasized motivational stages. A large international sample of European adolescents (N = 10,170, mean age = 13.3 years) was followed longitudinally. Self-reported motivational and behavioral stages of smoking initiation were integrated, leading to the development of the Model of Unplanned Smoking Initiation of Children and Adolescents (MUSICA). The MUSICA postulates that youngsters experiment with smoking while they are in an unmotivated state as regards their plans for smoking regularly in the future. More than 95% of the total population resided in one of the seven stages distinguished by MUSICA. The probability of starting to smoke regularly during the 12 months follow-up period increased with advanced stage assignment at baseline. Unique social cognitive predictors of stage progression from the various stages were identified, but effect sizes of predictors of transitions were small. The integration of motivational and behavioral dimensions improves our understanding of the process of smoking initiation. In contrast to current theories of smoking initiation, adolescent uptake of smoking behavior was found to be an unplanned action.

Index to FAA Office of Aviation Medicine reports : 1961 through 1991.

Science.gov (United States)

1992-01-01

An index to Office of Aviation Medicine Reports (1964-1991) and Civil Aeromedical Research Institute Reports (1961-1963) is presented as a reference for those engaged in aviation medicine and related activities. It lists all FAA aviation medicine rep...

An essential malaria protein defines the architecture of blood-stage and transmission-stage parasites.

Science.gov (United States)

Absalon, Sabrina; Robbins, Jonathan A; Dvorin, Jeffrey D

2016-04-28

Blood-stage replication of the human malaria parasite Plasmodium falciparum occurs via schizogony, wherein daughter parasites are formed by a specialized cytokinesis known as segmentation. Here we identify a parasite protein, which we name P. falciparum Merozoite Organizing Protein (PfMOP), as essential for cytokinesis of blood-stage parasites. We show that, following PfMOP knockdown, parasites undergo incomplete segmentation resulting in a residual agglomerate of partially divided cells. While organelles develop normally, the structural scaffold of daughter parasites, the inner membrane complex (IMC), fails to form in this agglomerate causing flawed segmentation. In PfMOP-deficient gametocytes, the IMC formation defect causes maturation arrest with aberrant morphology and death. Our results provide insight into the mechanisms of replication and maturation of malaria parasites.

Defining an abnormal first stage of labor based on maternal and neonatal outcomes

Science.gov (United States)

Harper, Lorie M.; Caughey, Aaron B.; Roehl, Kimberly A.; Odibo, Anthony O.; Cahill, Alison G.

2014-01-01

OBJECTIVE The objective of the study was to determine the threshold for defining abnormal labor that is associated with adverse maternal and neonatal outcomes. STUDY DESIGN This study consisted of a retrospective cohort of all consecutive women admitted at a gestation of 37.0 weeks or longer from 2004 to 2008 who reached the second stage of labor. The 90th, 95th, and 97th percentiles for progress in the first stage of labor were determined specific for parity and labor onset. Women with a first stage above and below each centile were compared. Maternal outcomes were cesarean delivery in the second stage, operative delivery, prolonged second stage, postpartum hemorrhage, and maternal fever. Neonatal outcomes were a composite of the following: admission to level 2 or 3 nursery, 5 minute Apgar less than 3, shoulder dystocia, arterial cord pH of less than 7.0, and a cord base excess of −12 or less. RESULTS Of the 5030 women, 4534 experienced first stage of less than the 90th percentile, 251 between the 90th and 94th percentiles, 102 between the 95th and 96th percentiles, and 143 at the 97th percentile or greater. Longer labors were associated with an increased risk of a prolonged second stage, maternal fever, the composite neonatal outcome, shoulder dystocia, and admission to a level 2 or 3 nursery (P dystocia. CONCLUSION Although women who experience labor dystocia may ultimately deliver vaginally, a longer first stage of labor is associated with adverse maternal and neonatal outcomes, in particular shoulder dystocia. This risk must be balanced against the risks of cesarean delivery for labor arrest. PMID:24361789

Index to FAA Office of Aviation Medicine reports : 1961 through 1978.

Science.gov (United States)

1979-01-01

An index to Office of Aviation Medicine Reports (1964-1978) and Civil Aeromedical Research Institute Reports (1961-1963) is presented as a reference for those engaged in aviation medicine and related activities. It provides a listing of all FAA aviat...

Index to FAA Office of Aviation Medicine reports : 1961 through 1980.

Science.gov (United States)

1981-01-01

An index to Office of Aviation Medicine Reports (1964-1978) and Civil Aeromedical Research Institute Reports (1961-1963) is presented as a reference for those engaged in aviation medicine and related activities. It provides a listing of all FAA aviat...

Index to FAA Office of Aviation Medicine reports : 1961 through 1986.

Science.gov (United States)

1987-01-01

An index to Office of Aviation Medicine Reports (1964-1982) and Civil Aeromedical Research Institute Reports (1961-1963) is presented as a reference for those engaged in aviation medicine and related activities. It provides a listing of all FAA aviat...

Index to FAA Office of Aviation Medicine reports : 1961 through 1971.

Science.gov (United States)

1972-03-01

An index to Office of Aviation Medicine Reports (1964-1971) and Civil Aeromedical Research Institute Reports (1961-1963) is presented as a quick reference for those engaged in aviation medicine and related activities. It provides a listing of all FAA...

Index to FAA Office of Aviation Medicine reports : 1961 through 1982.

Science.gov (United States)

1983-01-01

An index to Office of Aviation Medicine Reports (1964-1982) and Civil Aeromedical Research Institute Reports (1961-1963) is presented as a reference for those engaged in aviation medicine and related activities. It provides a listing of all FAA aviat...

Index to FAA Office of Aerospace Medicine reports : 1961 through 2012.

Science.gov (United States)

2013-01-01

An index to Office of Aviation Medicine Reports (1964-1971) and Civil Aeromedical Research Institute Reports (1961-1963) is presented as a quick reference for those engaged in aviation medicine and related activities. It provides a listing of all FAA...

A two staged condensation of vapors of an isobutane tower in installations for sulfuric acid alkylation

Energy Technology Data Exchange (ETDEWEB)

Smirnov, N.P.; Feyzkhanov, R.I.; Idrisov, A.D.; Navalikhin, P.G.; Sakharov, V.D.

1983-01-01

In order to increase the concentration of isobutane to greater than 72 to 76 percent in an installation for sulfuric acid alkylation, a system of two staged condensation of vapors from an isobutane tower is placed into operation. The first stage condenses the heavier part of the upper distillate of the tower, which is achieved through somewhat of an increase in the condensate temperature. The product which is condensed in the first stage is completely returned to the tower as a live irrigation. The vapors of the isobutane fraction which did not condense in the first stage are sent to two newly installed condensers, from which the product after condensation passes through intermediate tanks to further depropanization. The two staged condensation of vapors of the isobutane tower reduces the content of the inert diluents, the propane and n-butane in the upper distillate of the isobutane tower and creates more favorable conditions for the operation of the isobutane and propane tower.

Second stage gasifier in staged gasification and integrated process

Science.gov (United States)

Liu, Guohai; Vimalchand, Pannalal; Peng, Wan Wang

2015-10-06

A second stage gasification unit in a staged gasification integrated process flow scheme and operating methods are disclosed to gasify a wide range of low reactivity fuels. The inclusion of second stage gasification unit operating at high temperatures closer to ash fusion temperatures in the bed provides sufficient flexibility in unit configurations, operating conditions and methods to achieve an overall carbon conversion of over 95% for low reactivity materials such as bituminous and anthracite coals, petroleum residues and coke. The second stage gasification unit includes a stationary fluidized bed gasifier operating with a sufficiently turbulent bed of predefined inert bed material with lean char carbon content. The second stage gasifier fluidized bed is operated at relatively high temperatures up to 1400.degree. C. Steam and oxidant mixture can be injected to further increase the freeboard region operating temperature in the range of approximately from 50 to 100.degree. C. above the bed temperature.

Experimental study on an innovative multifunction heat pipe type heat recovery two-stage sorption refrigeration system

International Nuclear Information System (INIS)

Li, T.X.; Wang, R.Z.; Wang, L.W.; Lu, Z.S.

2008-01-01

An innovative multifunction heat pipe type sorption refrigeration system is designed, in which a two-stage sorption thermodynamic cycle based on two heat recovery processes was employed to reduce the driving heat source temperature, and the composite sorbent of CaCl 2 and activated carbon was used to improve the mass and heat transfer performances. For this test unit, the heating, cooling and heat recovery processes between two reactive beds are performed by multifunction heat pipes. The aim of this paper is to investigate the cycled characteristics of two-stage sorption refrigeration system with heat recovery processes. The two sub-cycles of a two-stage cycle have different sorption platforms though the adsorption and desorption temperatures are equivalent. The experimental results showed that the pressure evolutions of two beds are nearly equivalent during the first stage, and desorption pressure during the second stage is large higher than that in the first stage while the desorption temperatures are same during the two operation stages. In comparison with conventional two-stage cycle, the two-stage cycle with heat recovery processes can reduce the heating load for desorber and cooling load for adsorber, the coefficient of performance (COP) has been improved more than 23% when both cycles have the same regeneration temperature of 103 deg. C and the cooling water temperature of 30 deg. C. The advanced two-stage cycle provides an effective method for application of sorption refrigeration technology under the condition of low-grade temperature heat source or utilization of renewable energy

Staged membrane oxidation reactor system

Science.gov (United States)

Repasky, John Michael; Carolan, Michael Francis; Stein, VanEric Edward; Chen, Christopher Ming-Poh

2012-09-11

Ion transport membrane oxidation system comprising (a) two or more membrane oxidation stages, each stage comprising a reactant zone, an oxidant zone, one or more ion transport membranes separating the reactant zone from the oxidant zone, a reactant gas inlet region, a reactant gas outlet region, an oxidant gas inlet region, and an oxidant gas outlet region; (b) an interstage reactant gas flow path disposed between each pair of membrane oxidation stages and adapted to place the reactant gas outlet region of a first stage of the pair in flow communication with the reactant gas inlet region of a second stage of the pair; and (c) one or more reactant interstage feed gas lines, each line being in flow communication with any interstage reactant gas flow path or with the reactant zone of any membrane oxidation stage receiving interstage reactant gas.

[Automatic Sleep Stage Classification Based on an Improved K-means Clustering Algorithm].

Science.gov (United States)

Xiao, Shuyuan; Wang, Bei; Zhang, Jian; Zhang, Qunfeng; Zou, Junzhong

2016-10-01

Sleep stage scoring is a hotspot in the field of medicine and neuroscience.Visual inspection of sleep is laborious and the results may be subjective to different clinicians.Automatic sleep stage classification algorithm can be used to reduce the manual workload.However,there are still limitations when it encounters complicated and changeable clinical cases.The purpose of this paper is to develop an automatic sleep staging algorithm based on the characteristics of actual sleep data.In the proposed improved K-means clustering algorithm,points were selected as the initial centers by using a concept of density to avoid the randomness of the original K-means algorithm.Meanwhile,the cluster centers were updated according to the‘Three-Sigma Rule’during the iteration to abate the influence of the outliers.The proposed method was tested and analyzed on the overnight sleep data of the healthy persons and patients with sleep disorders after continuous positive airway pressure(CPAP)treatment.The automatic sleep stage classification results were compared with the visual inspection by qualified clinicians and the averaged accuracy reached 76%.With the analysis of morphological diversity of sleep data,it was proved that the proposed improved K-means algorithm was feasible and valid for clinical practice.

Simulation of a 3D unsteady flow in an axial turbine stage

Directory of Open Access Journals (Sweden)

Straka Petr

2012-04-01

Full Text Available The contribution deals with a numerical simulation of an unsteady flow in an axial turbine stage. The solution is performed using an in-house numerical code developed in the Aeronautical and Test Institute, Plc. in Prague. The numerical code is based on a finite volume discretization of governing equations (Favre averaged Navier-Stokes equations and a two-equations turbulence model. The temporal integration is based on the implicit second-order backward Euler formula, which is realized through the iteration process in dual time. The proposed numerical method is used for solution of the 3D, unsteady, viscous turbulent flow of a perfect gas in the axial turbine stage. The flow path consists of an input nozzle, stator blade-wheel, rotor blade-wheel, a shroud-seal gap and a diffuser. Attention is paid to the influence of a secondary flow structures, such as generated vortices and flow in shroud-seal gap.

The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report.

Science.gov (United States)

Monclair, Tom; Brodeur, Garrett M; Ambros, Peter F; Brisse, Hervé J; Cecchetto, Giovanni; Holmes, Keith; Kaneko, Michio; London, Wendy B; Matthay, Katherine K; Nuchtern, Jed G; von Schweinitz, Dietrich; Simon, Thorsten; Cohn, Susan L; Pearson, Andrew D J

2009-01-10

The International Neuroblastoma Risk Group (INRG) classification system was developed to establish a consensus approach for pretreatment risk stratification. Because the International Neuroblastoma Staging System (INSS) is a postsurgical staging system, a new clinical staging system was required for the INRG pretreatment risk classification system. To stage patients before any treatment, the INRG Task Force, consisting of neuroblastoma experts from Australia/New Zealand, China, Europe, Japan, and North America, developed a new INRG staging system (INRGSS) based on clinical criteria and image-defined risk factors (IDRFs). To investigate the impact of IDRFs on outcome, survival analyses were performed on 661 European patients with INSS stages 1, 2, or 3 disease for whom IDRFs were known. In the INGRSS, locoregional tumors are staged L1 or L2 based on the absence or presence of one or more of 20 IDRFs, respectively. Metastatic tumors are defined as stage M, except for stage MS, in which metastases are confined to the skin, liver, and/or bone marrow in children younger than 18 months of age. Within the 661-patient cohort, IDRFs were present (ie, stage L2) in 21% of patients with stage 1, 45% of patients with stage 2, and 94% of patients with stage 3 disease. Patients with INRGSS stage L2 disease had significantly lower 5-year event-free survival than those with INRGSS stage L1 disease (78% +/- 4% v 90% +/- 3%; P = .0010). Use of the new staging (INRGSS) and risk classification (INRG) of neuroblastoma will greatly facilitate the comparison of risk-based clinical trials conducted in different regions of the world.

Staging of gastroenteropancreatic neuroendocrine tumors: how we do it based on an evidence-based approach.

LENUS (Irish Health Repository)

McDermott, Shaunagh

2013-01-01

In contrast to other common types of malignant tumors, the vast majority of gastroenteropancreatic neuroendocrine tumors are well differentiated and slowly growing with only a minority showing aggressive behavior. It is important to accurately stage patients radiologically so the correct treatment can be implemented and to improve prognosis. In this article, we critically appraise the current literature in an effort to establish the current role of radiologic imaging in the staging of neuroendocrine tumors. We also discuss our protocol for staging neuroendocrine tumors.

Evaluation of an automated single-channel sleep staging algorithm

Directory of Open Access Journals (Sweden)

Wang Y

2015-09-01

Full Text Available Ying Wang,1 Kenneth A Loparo,1,2 Monica R Kelly,3 Richard F Kaplan1 1General Sleep Corporation, Euclid, OH, 2Department of Electrical Engineering and Computer Science, Case Western Reserve University, Cleveland, OH, 3Department of Psychology, University of Arizona, Tucson, AZ, USA Background: We previously published the performance evaluation of an automated electroencephalography (EEG-based single-channel sleep–wake detection algorithm called Z-ALG used by the Zmachine® sleep monitoring system. The objective of this paper is to evaluate the performance of a new algorithm called Z-PLUS, which further differentiates sleep as detected by Z-ALG into Light Sleep, Deep Sleep, and Rapid Eye Movement (REM Sleep, against laboratory polysomnography (PSG using a consensus of expert visual scorers. Methods: Single night, in-lab PSG recordings from 99 subjects (52F/47M, 18–60 years, median age 32.7 years, including both normal sleepers and those reporting a variety of sleep complaints consistent with chronic insomnia, sleep apnea, and restless leg syndrome, as well as those taking selective serotonin reuptake inhibitor/serotonin–norepinephrine reuptake inhibitor antidepressant medications, previously evaluated using Z-ALG were re-examined using Z-PLUS. EEG data collected from electrodes placed at the differential-mastoids (A1–A2 were processed by Z-ALG to determine wake and sleep, then those epochs detected as sleep were further processed by Z-PLUS to differentiate into Light Sleep, Deep Sleep, and REM. EEG data were visually scored by multiple certified polysomnographic technologists according to the Rechtschaffen and Kales criterion, and then combined using a majority-voting rule to create a PSG Consensus score file for each of the 99 subjects. Z-PLUS output was compared to the PSG Consensus score files for both epoch-by-epoch (eg, sensitivity, specificity, and kappa and sleep stage-related statistics (eg, Latency to Deep Sleep, Latency to REM

Dental Age Estimation (DAE): Data management for tooth development stages including the third molar. Appropriate censoring of Stage H, the final stage of tooth development.

Science.gov (United States)

Roberts, Graham J; McDonald, Fraser; Andiappan, Manoharan; Lucas, Victoria S

2015-11-01

The final stage of dental development of third molars is usually helpful to indicate whether or not a subject is aged over 18 years. A complexity is that the final stage of development is unlimited in its upper border. Investigators usually select an inappropriate upper age limit or censor point for this tooth development stage. The literature was searched for appropriate data sets for dental age estimation and those that provided the count (n), the mean (x¯), and the standard deviation (sd) for each of the tooth development stages. The Demirjian G and Demirjian H were used for this study. Upper and lower limits of the Stage G and Stage H data were calculated limiting the data to plus or minus three standard deviations from the mean. The upper border of Stage H was limited by appropriate censoring at the maximum value for Stage G. The maximum age at attainment from published data, for Stage H, ranged from 22.60 years to 34.50 years. These data were explored to demonstrate how censoring provides an estimate for the correct maximum age for the final stage of Stage H as 21.64 years for UK Caucasians. This study shows that confining the data array of individual tooth developments stages to ± 3sd provides a reliable and logical way of censoring the data for tooth development stages with a Normal distribution of data. For Stage H this is inappropriate as it is unbounded in its upper limit. The use of a censored data array for Stage H using Percentile values is appropriate. This increases the reliability of using third molar Stage H alone to determine whether or not an individual is over 18 years old. For Stage H, individual ancestral groups should be censored using the same technique. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Saudis map $450 million gulf spill cleanup

International Nuclear Information System (INIS)

Anon.

1991-01-01

This paper reports on Saudi Arabia which has earmarked about $450 million to clean up Persian Gulf beaches polluted by history's worst oil spills, created during the Persian Gulf crisis. Details of the proposed cleanup measures were outlined by Saudi environmental officials at a seminar on the environment in Dubai, OPEC News Agency reported. The seminar was sponsored by the Gulf Area Oil Companies Mutual Aid Organization, an environmental cooperative agency set up by Persian Gulf governments. Meantime, a Saudi government report has outlined early efforts designed to contain the massive oil spills that hit the Saudi coast before oil could contaminate water intakes at the huge desalination plants serving Riyadh and cooling water facilities at Al Jubail

Accuracy of the One-Stage and Two-Stage Impression Techniques: A Comparative Analysis.

Science.gov (United States)

Jamshidy, Ladan; Mozaffari, Hamid Reza; Faraji, Payam; Sharifi, Roohollah

2016-01-01

Introduction . One of the main steps of impression is the selection and preparation of an appropriate tray. Hence, the present study aimed to analyze and compare the accuracy of one- and two-stage impression techniques. Materials and Methods . A resin laboratory-made model, as the first molar, was prepared by standard method for full crowns with processed preparation finish line of 1 mm depth and convergence angle of 3-4°. Impression was made 20 times with one-stage technique and 20 times with two-stage technique using an appropriate tray. To measure the marginal gap, the distance between the restoration margin and preparation finish line of plaster dies was vertically determined in mid mesial, distal, buccal, and lingual (MDBL) regions by a stereomicroscope using a standard method. Results . The results of independent test showed that the mean value of the marginal gap obtained by one-stage impression technique was higher than that of two-stage impression technique. Further, there was no significant difference between one- and two-stage impression techniques in mid buccal region, but a significant difference was reported between the two impression techniques in MDL regions and in general. Conclusion . The findings of the present study indicated higher accuracy for two-stage impression technique than for the one-stage impression technique.

The influence of magnetic field strength in ionization stage on ion transport between two stages of a double stage Hall thruster

International Nuclear Information System (INIS)

Yu Daren; Song Maojiang; Li Hong; Liu Hui; Han Ke

2012-01-01

It is futile for a double stage Hall thruster to design a special ionization stage if the ionized ions cannot enter the acceleration stage. Based on this viewpoint, the ion transport under different magnetic field strengths in the ionization stage is investigated, and the physical mechanisms affecting the ion transport are analyzed in this paper. With a combined experimental and particle-in-cell simulation study, it is found that the ion transport between two stages is chiefly affected by the potential well, the potential barrier, and the potential drop at the bottom of potential well. With the increase of magnetic field strength in the ionization stage, there is larger plasma density caused by larger potential well. Furthermore, the potential barrier near the intermediate electrode declines first and then rises up while the potential drop at the bottom of potential well rises up first and then declines as the magnetic field strength increases in the ionization stage. Consequently, both the ion current entering the acceleration stage and the total ion current ejected from the thruster rise up first and then decline as the magnetic field strength increases in the ionization stage. Therefore, there is an optimal magnetic field strength in the ionization stage to guide the ion transport between two stages.

Controlling the COD removal of an A-stage pilot study with instrumentation and automatic process control.

Science.gov (United States)

Miller, Mark W; Elliott, Matt; DeArmond, Jon; Kinyua, Maureen; Wett, Bernhard; Murthy, Sudhir; Bott, Charles B

2017-06-01

The pursuit of fully autotrophic nitrogen removal via the anaerobic ammonium oxidation (anammox) pathway has led to an increased interest in carbon removal technologies, particularly the A-stage of the adsorption/bio-oxidation (A/B) process. The high-rate operation of the A-stage and lack of automatic process control often results in wide variations of chemical oxygen demand (COD) removal that can ultimately impact nitrogen removal in the downstream B-stage process. This study evaluated the use dissolved oxygen (DO) and mixed liquor suspended solids (MLSS) based automatic control strategies through the use of in situ on-line sensors in the A-stage of an A/B pilot study. The objective of using these control strategies was to reduce the variability of COD removal by the A-stage and thus the variability of the effluent C/N. The use of cascade DO control in the A-stage did not impact COD removal at the conditions tested in this study, likely because the bulk DO concentration (>0.5 mg/L) was maintained above the half saturation coefficient of heterotrophic organisms for DO. MLSS-based solids retention time (SRT) control, where MLSS was used as a surrogate for SRT, did not significantly reduce the effluent C/N variability but it was able to reduce COD removal variation in the A-stage by 90%.

Results of an Advanced Fan Stage Operating Over a Wide Range of Speed and Bypass Ratio. Part 1; Fan Stage Design and Experimental Results

Science.gov (United States)

Suder, Kenneth L.; Prahst, Patricia S.; Thorp, Scott A.

2011-01-01

NASA s Fundamental Aeronautics Program is investigating turbine-based combined cycle (TBCC) propulsion systems for access to space because it provides the potential for aircraft-like, space-launch operations that may significantly reduce launch costs and improve safety. To this end, National Aeronautics and Space Administration (NASA) and General Electric (GE) teamed to design a Mach 4 variable cycle turbofan/ramjet engine for access to space. To enable the wide operating range of a Mach 4+ variable cycle turbofan ramjet required the development of a unique fan stage design capable of multi-point operation to accommodate variations in bypass ratio (10 ), fan speed (7 ), inlet mass flow (3.5 ), inlet pressure (8 ), and inlet temperature (3 ). In this paper, NASA has set out to characterize a TBCC engine fan stage aerodynamic performance and stability limits over a wide operating range including power-on and hypersonic-unique "windmill" operation. Herein, we will present the fan stage design, and the experimental test results of the fan stage operating from 15 to 100 percent corrected design speed. Whereas, in the companion paper, we will provide an assessment of NASA s APNASA code s ability to predict the fan stage performance and operability over a wide range of speed and bypass ratio.

Intestinal diffuse large B-cell lymphoma: an evaluation of different staging systems.

Science.gov (United States)

Hwang, Hee Sang; Yoon, Dok Hyun; Suh, Cheolwon; Park, Chan-Sik; Huh, Jooryung

2014-01-01

The gastrointestinal tract is the most common primary extranodal site for diffuse large B-cell lymphoma (DLBCL). However, there is no consensus on the most appropriate staging system for intestinal DLBCL. We evaluated the utility of the modified Ann Arbor system, the Lugano system, and the Paris staging system (a modification of the Tumor, Node, Metastases [TNM] staging for epithelial tumors) in 66 cases of resected intestinal DLBCL. The cases were treated with surgery, plus either cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy alone (n=26) or with the addition of rituximab immunotherapy (n=40). Median follow-up time was 40.4 months (range, 2.1-171.6 months). Fifty-six patients (84.8%) achieved complete remission. The overall 5-yr survival rate was 86.4% (57/66). Of the stage categories defined for each staging system, only the T stage of the Paris classification showed prognostic significance for overall survival by univariate analysis. However, none of the stage parameters was significantly correlated with patient survival on multivariate analysis. In conclusion, the results suggest that the T stage of the Paris classification system may be a prognostic indicator in intestinal DLBCL. The results also imply that in surgically resected intestinal DLBCL, the addition of rituximab to the CHOP regimen does not confer significant survival advantage.

Urinary bladder cancer T-staging from T2-weighted MR images using an optimal biomarker approach

Science.gov (United States)

Wang, Chuang; Udupa, Jayaram K.; Tong, Yubing; Chen, Jerry; Venigalla, Sriram; Odhner, Dewey; Guzzo, Thomas J.; Christodouleas, John; Torigian, Drew A.

2018-02-01

Magnetic resonance imaging (MRI) is often used in clinical practice to stage patients with bladder cancer to help plan treatment. However, qualitative assessment of MR images is prone to inaccuracies, adversely affecting patient outcomes. In this paper, T2-weighted MR image-based quantitative features were extracted from the bladder wall in 65 patients with bladder cancer to classify them into two primary tumor (T) stage groups: group 1 - T stage T2, with primary tumor locally confined to the bladder, and group 2 - T stage T2, with primary tumor locally extending beyond the bladder. The bladder was divided into 8 sectors in the axial plane, where each sector has a corresponding reference standard T stage that is based on expert radiology qualitative MR image review and histopathologic results. The performance of the classification for correct assignment of T stage grouping was then evaluated at both the patient level and the sector level. Each bladder sector was divided into 3 shells (inner, middle, and outer), and 15,834 features including intensity features and texture features from local binary pattern and gray-level co-occurrence matrix were extracted from the 3 shells of each sector. An optimal feature set was selected from all features using an optimal biomarker approach. Nine optimal biomarker features were derived based on texture properties from the middle shell, with an area under the ROC curve of AUC value at the sector and patient level of 0.813 and 0.806, respectively.

[An unexpected stage of alkalosis in the dynamics of the early posthemorrhagic period].

Science.gov (United States)

Beliaev, A V

2000-01-01

A study was made on acid-base metabolism in early posthemorrhagic period as exemplified by examination of patients presenting with gastrointestinal hemorrhage. It has been ascertained that hemorrhage is accompanied by a mixed variant of the acid-base state (ABS) deviation, namely metabolic lactate-acidosis and respiratory alkalosis. In the time-related course of posthemorrhagic period such deviations persist in patients with lethal outcome; with the disease running a favourable course the above deviations are found to return to normal quite soon. The development of complications leads to staging in ABC, its stages being as follows: stage I--the initial stage, stage II--persisting metabolic acidosis and respiratory alkalosis, stage III--alkalosis, stage IV--normalization, with stage III of ABS being encouraged by hypocapnia caused by function disorders of the lungs in early posthemorrhagic period, normalization of cell metabolism, increase in the rate of urination as a reflection of the third earlier identified stage of water metabolism, with the H+ excretion in the urine at the previous level. The identified ABS stage III threatens coming trouble, being accompanied by metabolic deviations together with a risk of function disorder of the myocardium.

Staging of laser-plasma accelerators

Energy Technology Data Exchange (ETDEWEB)

Steinke, S., E-mail: ssteinke@lbl.gov; Tilborg, J. van; Benedetti, C.; Geddes, C. G. R.; Gonsalves, A. J.; Nakamura, K.; Schroeder, C. B.; Esarey, E. [Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States); Daniels, J. [Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States); Eindhoven University of Technology, PO Box 513, 5600MB Eindhoven (Netherlands); Swanson, K. K.; Shaw, B. H.; Leemans, W. P. [Lawrence Berkeley National Laboratory, Berkeley, California 94720 (United States); University of California, Berkeley, California 94720 (United States)

2016-05-15

We present results of an experiment where two laser-plasma-accelerator stages are coupled at a short distance by a plasma mirror. Stable electron beams from the first stage were used to longitudinally probe the dark-current-free, quasi-linear wakefield excited by the laser of the second stage. Changing the arrival time of the electron beam with respect to the second stage laser pulse allowed reconstruction of the temporal wakefield structure, determination of the plasma density, and inference of the length of the electron beam. The first stage electron beam could be focused by an active plasma lens to a spot size smaller than the transverse wake size at the entrance of the second stage. This permitted electron beam trapping, verified by a 100 MeV energy gain.

Accuracy of the One-Stage and Two-Stage Impression Techniques: A Comparative Analysis

Directory of Open Access Journals (Sweden)

Ladan Jamshidy

2016-01-01

Full Text Available Introduction. One of the main steps of impression is the selection and preparation of an appropriate tray. Hence, the present study aimed to analyze and compare the accuracy of one- and two-stage impression techniques. Materials and Methods. A resin laboratory-made model, as the first molar, was prepared by standard method for full crowns with processed preparation finish line of 1 mm depth and convergence angle of 3-4°. Impression was made 20 times with one-stage technique and 20 times with two-stage technique using an appropriate tray. To measure the marginal gap, the distance between the restoration margin and preparation finish line of plaster dies was vertically determined in mid mesial, distal, buccal, and lingual (MDBL regions by a stereomicroscope using a standard method. Results. The results of independent test showed that the mean value of the marginal gap obtained by one-stage impression technique was higher than that of two-stage impression technique. Further, there was no significant difference between one- and two-stage impression techniques in mid buccal region, but a significant difference was reported between the two impression techniques in MDL regions and in general. Conclusion. The findings of the present study indicated higher accuracy for two-stage impression technique than for the one-stage impression technique.

Tools for Reactive Distillation Column Design: Graphical and Stage-to-Stage Computation Methods

DEFF Research Database (Denmark)

Sanchez Daza, O.; Cisneros, Eduardo Salvador P.; Hostrup, Martin

2001-01-01

Based on the element mass balance concept, a graphical design method and a stage-to-stage multicomponent design method for reactive distillation columns have been developed. For distillation columns comprising reactive and non-reactive stages, a simple design strategy based on reactive and non......-reactive bubble point calculations is proposed. This strategy tracks the conversion and temperature between the feed and the end stages of the column. An illustrative example highlights the verification of the design strategy through rigorous simulation....

Differentiating between light and deep sleep stages using an ambulatory device based on peripheral arterial tonometry

International Nuclear Information System (INIS)

Bresler, Ma'ayan; Sheffy, Koby; Preiszler, Meir; Herscovici, Sarah; Pillar, Giora

2008-01-01

The objective of this study is to develop and assess an automatic algorithm based on the peripheral arterial tone (PAT) signal to differentiate between light and deep sleep stages. The PAT signal is a measure of the pulsatile arterial volume changes at the finger tip reflecting sympathetic tone variations and is recorded by an ambulatory unattended device, the Watch-PAT100, which has been shown to be capable of detecting wake, NREM and REM sleep. An algorithm to differentiate light from deep sleep was developed using a training set of 49 patients and was validated using a separate set of 44 patients. In both patient sets, Watch-PAT100 data were recorded simultaneously with polysomnography during a full night sleep study. The algorithm is based on 14 features extracted from two time series of PAT amplitudes and inter-pulse periods (IPP). Those features were then further processed to yield a prediction function that determines the likelihood of detecting a deep sleep stage epoch during NREM sleep periods. Overall sensitivity, specificity and agreement of the automatic algorithm to identify standard 30 s epochs of light and deep sleep stages were 66%, 89%, 82% and 65%, 87%, 80% for the training and validation sets, respectively. Together with the already existing algorithms for REM and wake detection we propose a close to full stage detection method based solely on the PAT and actigraphy signals. The automatic sleep stages detection algorithm could be very useful for unattended ambulatory sleep monitoring assessing sleep stages when EEG recordings are not available

Developmental stages of an African child and their psychological implications: a comparative study

OpenAIRE

2008-01-01

D. Phil. Human development is a universal phenomenon, characterized by various stages. These stages differ from one culture to the other. Furthermore, each developmental stage tends to bring about expectations that are in accordance with a particular culture. In addition, in each culture there exist problems that are specific to a given stage as well as to the manner in which these problems are resolved. Erikson=s stages of human development are generally regarded as universal. The univers...

Carbon stocks and dynamics at different successional stages in an Afromontane tropical forest

Science.gov (United States)

Nyirambangutse, Brigitte; Zibera, Etienne; Uwizeye, Félicien K.; Nsabimana, Donat; Bizuru, Elias; Pleijel, Håkan; Uddling, Johan; Wallin, Göran

2017-03-01

As a result of different types of disturbance, forests are a mixture of stands at different stages of ecological succession. Successional stage is likely to influence forest productivity and carbon storage, linking the degree of forest disturbance to the global carbon cycle and climate. Although tropical montane forests are an important part of tropical forest ecosystems (ca. 8 %, elevation > 1000 m a.s.l.), there are still significant knowledge gaps regarding the carbon dynamics and stocks of these forests, and how these differ between early (ES) and late successional (LS) stages. This study examines the carbon (C) stock, relative growth rate (RGR) and net primary production (NPP) of ES and LS forest stands in an Afromontane tropical rainforest using data from inventories of quantitatively important ecosystem compartments in fifteen 0.5 ha plots in Nyungwe National Park in Rwanda. The total C stock was 35 % larger in LS compared to ES plots due to significantly larger above-ground biomass (AGB; 185 and 76 Mg C ha-1 in LS and ES plots), while the soil and root C stock (down to 45 cm depth in the mineral soil) did not significantly differ between the two successional stages (178 and 204 Mg C ha-1 in LS and ES plots). The main reasons for the difference in AGB were that ES trees had significantly lower stature and wood density compared to LS trees. However, ES and LS stands had similar total NPP (canopy, wood and roots of all plots ˜ 9.4 Mg C ha-1) due to counterbalancing effects of differences in AGB (higher in LS stands) and RGR (higher in ES stands). The AGB in the LS plots was considerably higher than the average value reported for old-growth tropical montane forest of south-east Asia and Central and South America at similar elevations and temperatures, and of the same magnitude as in tropical lowland forest of these regions. The results of this study highlight the importance of accounting for disturbance regimes and differences in wood density and allometry of

Stage-by-Stage and Parallel Flow Path Compressor Modeling for a Variable Cycle Engine

Science.gov (United States)

Kopasakis, George; Connolly, Joseph W.; Cheng, Larry

2015-01-01

This paper covers the development of stage-by-stage and parallel flow path compressor modeling approaches for a Variable Cycle Engine. The stage-by-stage compressor modeling approach is an extension of a technique for lumped volume dynamics and performance characteristic modeling. It was developed to improve the accuracy of axial compressor dynamics over lumped volume dynamics modeling. The stage-by-stage compressor model presented here is formulated into a parallel flow path model that includes both axial and rotational dynamics. This is done to enable the study of compressor and propulsion system dynamic performance under flow distortion conditions. The approaches utilized here are generic and should be applicable for the modeling of any axial flow compressor design.

Stage line diagram: An age-conditional reference diagram for tracking development

NARCIS (Netherlands)

Buuren, S. van; Ooms, J.C.L.

2009-01-01

This paper presents a method for calculating stage line diagrams, a novel type of reference diagram useful for tracking developmental processes over time. Potential fields of applications include: dentistry (tooth eruption), oncology (tumor grading, cancer staging), virology (HIV infection and

Stage line diagram: an age-conditional reference diagram for tracking development.

NARCIS (Netherlands)

Van Buuren, S.; Ooms, J.C.L.

2009-01-01

This paper presents a method for calculating stage line diagrams, a novel type of reference diagram useful for tracking developmental processes over time. Potential fields of applications include: dentistry (tooth eruption), oncology (tumor grading, cancer staging), virology (HIV infection and

Are stage IV vestibular schwannomas preoperatively different from other stages?

Science.gov (United States)

Tringali, Stéphane; Dubreuil, Christian; Zaouche, Sandra; Ferber-Viart, Chantal

2008-01-01

The aim of this study was to focus on the clinical and paraclinical symptoms of patients suffering from Stage IV vestibular schwannomas (VSs). In this prospective study, we included 734 patients who have VS and candidates for operation. Patients were classified as having Stage I, II, III, or IV tumors according to Tos criteria as evaluated by magnetic resonance imaging. PREOPERATIVE CLINICAL EVALUATION: We recorded the occurrence of complaints (%) and duration (yr) of hearing loss, tinnitus, and balance disorder. Preoperative paraclinical evaluation included pure-tone (PTA) and speech audiometry, auditory brainstem response (ABR) patterns, and vestibular deficit at videonystamography (VNG). Continuous variables were compared between Stage IV and other stages using analysis of variance. Qualitative variables expressed as a percentage of presence were compared between Stage IV and other stages using percentage comparison. Quantitative Parameters. Patients with Stage IV VS were significantly younger as compared with patients with other stages. Stage IV hearing loss was greater compared with other stages at 250 and 500 Hz but smaller at 2,000 and 8,000 Hz. We found no difference in the loss of PTA between Stage IV and the other stages. Speech discriminancy score was smaller in Stage IV. The durations of hearing loss, tinnitus, and balance disorders were similar whatever the tumor stage. Auditory brainstem response patterns showed no difference in Wave III latency between Stage IV VS and other stages, whereas Wave V latency and V-I interval were higher in Stage IV. Both ABR threshold and VNG caloric deficit were higher in Stage IV VS compared with other stages. Qualitative Parameters. The percentage of patients with Stage IV was lower than that with Stages II and III. The percentage of men and women was similar in all stages. The occurrence of hearing loss was similar in all stages, whereas that of tinnitus was lower in Stage IV compared with Stages I and II. In

Seven Stages of Alzheimer's

Science.gov (United States)

... Disease > Stages Overview What Is Dementia? What Is Alzheimer's? Younger/Early Onset Facts and Figures Know the 10 Signs Stages Inside the Brain: An Interactive Tour Risk Factors Diagnosis Treatments Myths Clinical Studies Research Brain Donation ...

Performance of an iterative two-stage bayesian technique for population pharmacokinetic analysis of rich data sets

NARCIS (Netherlands)

Proost, Johannes H.; Eleveld, Douglas J.

2006-01-01

Purpose. To test the suitability of an Iterative Two-Stage Bayesian (ITSB) technique for population pharmacokinetic analysis of rich data sets, and to compare ITSB with Standard Two-Stage (STS) analysis and nonlinear Mixed Effect Modeling (MEM). Materials and Methods. Data from a clinical study with

Impact of two-stage turbocharging architectures on pumping losses of automotive engines based on an analytical model

International Nuclear Information System (INIS)

Galindo, J.; Serrano, J.R.; Climent, H.; Varnier, O.

2010-01-01

Present work presents an analytical study of two-stage turbocharging configuration performance. The aim of this work is to understand the influence of different two-stage-architecture parameters to optimize the use of exhaust manifold gases energy and to aid decision making process. An analytical model giving the relationship between global compression ratio and global expansion ratio is developed as a function of basic engine and turbocharging system parameters. Having an analytical solution, the influence of different variables, such as expansion ratio between HP and LP turbine, intercooler efficiency, turbochargers efficiency, cooling fluid temperature and exhaust temperature are studied independently. Engine simulations with proposed analytical model have been performed to analyze the influence of these different parameters on brake thermal efficiency and pumping mean effective pressure. The results obtained show the overall performance of the two-stage system for the whole operative range and characterize the optimum control of the elements for each operative condition. The model was also used to compare single-stage and two-stage architectures performance for the same engine operative conditions. Benefits and limits in terms of breathing capabilities and brake thermal efficiency of each type of system have been presented and analyzed.

Clinical potentials of methylator phenotype in stage 4 high-risk neuroblastoma: an open challenge.

Directory of Open Access Journals (Sweden)

Barbara Banelli

Full Text Available Approximately 20% of stage 4 high-risk neuroblastoma patients are alive and disease-free 5 years after disease onset while the remaining experience rapid and fatal progression. Numerous findings underline the prognostic role of methylation of defined target genes in neuroblastoma without taking into account the clinical and biological heterogeneity of this disease. In this report we have investigated the methylation of the PCDHB cluster, the most informative member of the "Methylator Phenotype" in neuroblastoma, hypothesizing that if this epigenetic mark can predict overall and progression free survival in high-risk stage 4 neuroblastoma, it could be utilized to improve the risk stratification of the patients, alone or in conjunction with the previously identified methylation of the SFN gene (14.3.3sigma that can accurately predict outcome in these patients. We have utilized univariate and multivariate models to compare the prognostic power of PCDHB methylation in terms of overall and progression free survival, quantitatively determined by pyrosequencing, with that of other markers utilized for the patients' stratification utilizing methylation thresholds calculated on neuroblastoma at stage 1-4 and only on stage 4, high-risk patients. Our results indicate that PCDHB accurately distinguishes between high- and intermediate/low risk stage 4 neuroblastoma in agreement with the established risk stratification criteria. However PCDHB cannot predict outcome in the subgroup of stage 4 patients at high-risk whereas methylation levels of SFN are suggestive of a "methylation gradient" associated with tumor aggressiveness as suggested by the finding of a higher threshold that defines a subset of patients with an extremely severe disease (OS <24 months. Because of the heterogeneity of neuroblastoma we believe that clinically relevant methylation markers should be selected and tested on homogeneous groups of patients rather than on patients at all stages.

A numerical study of cavitation phenomenon in a flapper-nozzle pilot stage of an electrohydraulic servo-valve with an innovative flapper shape

International Nuclear Information System (INIS)

Aung, Nay Zar; Li, Songjing

2014-01-01

Highlights: • The flapper with curved edge develops a significant cavitation in pilot stage. • The rectangular shape flapper significantly reduces cavitation in pilot stage. • The innovative flapper eliminates undesired transverse lateral force. • The innovative flapper maintains the same flow control capability and construction. - Abstract: The flapper-nozzle pilot stage, whose performance can be deteriorated by the generated flow cavitation phenomenon, is a vital segment in achieving precise control of electrohydraulic servo-valves. Aiming to find out a reasonable flapper shape to reduce cavitation, this paper presents a numerical study of cavitation phenomenon in a flapper-nozzle pilot stage with different flapper shapes. A simple rectangular shape, carefully designed without disturbing the flow control characteristics of the pilot stage, is set as an innovative flapper shape in this work. Cavitation phenomena in the pilot stage are simulated for both of the traditionally used flapper shape and the innovative flapper shape at flow conditions with various nozzle inlet pressures, 1 MPa to 7 MPa. Then, systematic comparison of resulted cavitation phenomena for the two different flapper shapes is carried out. The results confirm that, for both flapper shapes, cavitation commonly occurs along the nozzle tip wall beyond stagnation region. The curved edge in traditionally used flapper shape is a massive contributor of cavitation in the pilot stage and the selected innovative shape shows a significant reduction of cavitation on its surface. From the flow structure, it is also noticeable that undesired transverse lateral force of sheded vortices is eliminated by using the innovative flapper shape. Meanwhile, the innovative flapper shape highlights the same effectiveness on the performance of flow control as the traditionally used flapper shape. Thus, a simple and effective flapper shape is proposed for cavitation reduction in the flapper-nozzle pilot stage of an

Imaging and detection of early stage dental caries with an all-optical photoacoustic microscope

Science.gov (United States)

Hughes, D. A.; Sampathkumar, A.; Longbottom, C.; Kirk, K. J.

2015-01-01

Tooth decay, at its earliest stages, manifests itself as small, white, subsurface lesions in the enamel. Current methods for detection in the dental clinic are visual and tactile investigations, and bite-wing X-ray radiographs. These techniques suffer from poor sensitivity and specificity at the earliest (and reversible) stages of the disease due to the small size (tooth decay. Ex-vivo tooth samples exhibiting white spot lesions were scanned and were found to generate a larger (one order of magnitude) photoacoustic (PA) signal in the lesion regions compared to healthy enamel. The high contrast in the PA images potentially allows lesions to be imaged and measured at a much earlier stage than current clinical techniques allow. PA images were cross referenced with histology photographs to validate our experimental results. Our PA system provides a noncontact method for early detection of white-spot lesions with a high detection bandwidth that offers advantages over previously demonstrated ultrasound methods. The technique provides the sensing depth of an ultrasound system, but with the spatial resolution of an optical system.

Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

Science.gov (United States)

2017-05-03

Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IB Fallopian Tube Cancer; Stage IC Fallopian Tube Cancer; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIB Fallopian Tube Cancer; Stage IIC Fallopian Tube Cancer; Stage III Ovarian Cancer; Stage III Primary Peritoneal Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIC Fallopian Tube Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

Comparative effectiveness of one-stage versus two-stage basilic vein transposition arteriovenous fistulas.

Science.gov (United States)

Ghaffarian, Amir A; Griffin, Claire L; Kraiss, Larry W; Sarfati, Mark R; Brooke, Benjamin S

2018-02-01

between groups in use of interventions (58% for one-stage BVT vs 51% for two-stage BVT; P = .5) to maintain patency. These findings were confirmed in multivariate analysis, in which two-stage BVTs were associated with a significantly lower rate of failure (hazard ratio, 0.39; 95% confidence interval, 0.2-0.8; P < .05) than one-stage BVTs after controlling for confounding variables. Finally, the two-stage BVT was more cost-effective (3.74 QALYs for two-stage BVT vs 3.32 QALYs for one-stage BVT) during 5 years, with an incremental cost-effectiveness ratio of $4681 per QALY. Our data show that two-stage BVTs are more durable and cost-effective than one-stage procedures, with significantly higher patency and lower rates of failure among comparable risk-stratified patients. These findings suggest that additional upfront costs and resources associated with creating two-stage BVTs are justified by their long-term outcomes. Published by Elsevier Inc.

Effects of gamma irradiation of an isolated flower in reproductive stages on seed production of Brassica napus L

International Nuclear Information System (INIS)

Minami, Harufumi; Sakurai, Noboru; Muroyama, Takeo; Hogetsu, Daisuke

1999-01-01

We examined seed production after gamma irradiation of an isolated whole flower (a flower with pedicel) of Brassica napus strain 1 through a flower organ culture and estimated the effects of gamma rays on embryogenesis in sexual reproductive stages. The whole flowers were irradiated with 17, 32, 57 and 87 Gy of gamma rays in unpollinated stage at day of anthesis, in stage shortly after fertilization and early embryo stage. The gamma irradiation of flowers in stage shortly after fertilization showed a drastic effect on the mature seed production. The number of seeds per pod began to decrease at 17 Gy and dropped to 15% of that of unirradiated flowers at 32 Gy. On the other hand, the flowers irradiated in the unpollinated and early embryo stages began to reduce the number of seeds at 57 Gy. The ovary elongation was suppressed with increasing irradiation dose when the flower was irradiated in unpollinated stage and stage shortly after fertilization. (author)

Meta‐analysis using individual participant data: one‐stage and two‐stage approaches, and why they may differ

Science.gov (United States)

Ensor, Joie; Riley, Richard D.

2016-01-01

Meta‐analysis using individual participant data (IPD) obtains and synthesises the raw, participant‐level data from a set of relevant studies. The IPD approach is becoming an increasingly popular tool as an alternative to traditional aggregate data meta‐analysis, especially as it avoids reliance on published results and provides an opportunity to investigate individual‐level interactions, such as treatment‐effect modifiers. There are two statistical approaches for conducting an IPD meta‐analysis: one‐stage and two‐stage. The one‐stage approach analyses the IPD from all studies simultaneously, for example, in a hierarchical regression model with random effects. The two‐stage approach derives aggregate data (such as effect estimates) in each study separately and then combines these in a traditional meta‐analysis model. There have been numerous comparisons of the one‐stage and two‐stage approaches via theoretical consideration, simulation and empirical examples, yet there remains confusion regarding when each approach should be adopted, and indeed why they may differ. In this tutorial paper, we outline the key statistical methods for one‐stage and two‐stage IPD meta‐analyses, and provide 10 key reasons why they may produce different summary results. We explain that most differences arise because of different modelling assumptions, rather than the choice of one‐stage or two‐stage itself. We illustrate the concepts with recently published IPD meta‐analyses, summarise key statistical software and provide recommendations for future IPD meta‐analyses. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. PMID:27747915

Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers.

Science.gov (United States)

Romanò, C L; Gala, L; Logoluso, N; Romanò, D; Drago, L

2012-12-01

The best method for treating chronic periprosthetic knee infection remains controversial. Randomized, comparative studies on treatment modalities are lacking. This systematic review of the literature compares the infection eradication rate after two-stage versus one-stage revision and static versus articulating spacers in two-stage procedures. We reviewed full-text papers and those with an abstract in English published from 1966 through 2011 that reported the success rate of infection eradication after one-stage or two-stage revision with two different types of spacers. In all, 6 original articles reporting the results after one-stage knee exchange arthoplasty (n = 204) and 38 papers reporting on two-stage revision (n = 1,421) were reviewed. The average success rate in the eradication of infection was 89.8% after a two-stage revision and 81.9% after a one-stage procedure at a mean follow-up of 44.7 and 40.7 months, respectively. The average infection eradication rate after a two-stage procedure was slightly, although significantly, higher when an articulating spacer rather than a static spacer was used (91.2 versus 87%). The methodological limitations of this study and the heterogeneous material in the studies reviewed notwithstanding, this systematic review shows that, on average, a two-stage procedure is associated with a higher rate of eradication of infection than one-stage revision for septic knee prosthesis and that articulating spacers are associated with a lower recurrence of infection than static spacers at a comparable mean duration of follow-up. IV.

A novel wavelet neural network based pathological stage detection technique for an oral precancerous condition

Science.gov (United States)

Paul, R R; Mukherjee, A; Dutta, P K; Banerjee, S; Pal, M; Chatterjee, J; Chaudhuri, K; Mukkerjee, K

2005-01-01

Aim: To describe a novel neural network based oral precancer (oral submucous fibrosis; OSF) stage detection method. Method: The wavelet coefficients of transmission electron microscopy images of collagen fibres from normal oral submucosa and OSF tissues were used to choose the feature vector which, in turn, was used to train the artificial neural network. Results: The trained network was able to classify normal and oral precancer stages (less advanced and advanced) after obtaining the image as an input. Conclusions: The results obtained from this proposed technique were promising and suggest that with further optimisation this method could be used to detect and stage OSF, and could be adapted for other conditions. PMID:16126873

QUICKGUN: An algorithm for estimating the performance of two-stage light gas guns

International Nuclear Information System (INIS)

Milora, S.L.; Combs, S.K.; Gouge, M.J.; Kincaid, R.W.

1990-09-01

An approximate method is described for solving the equation of motion of a projectile accelerated by a two-stage light gas gun that uses high-pressure (<100-bar) gas from a storage reservoir to drive a piston to moderate speed (<400 m/s) for the purpose of compressing the low molecular weight propellant gas (hydrogen or helium) to high pressure (1000 to 10,000 bar) and temperature (1000 to 10,000 K). Zero-dimensional, adiabatic (isentropic) processes are used to describe the time dependence of the ideal gas thermodynamic properties of the storage reservoir and the first and second stages of the system. A one-dimensional model based on an approximate method of characteristics, or wave diagram analysis, for flow with friction (nonisentropic) is used to describe the nonsteady compressible flow processes in the launch tube. Linear approximations are used for the characteristic and fluid particle trajectories by averaging the values of the flow parameters at the breech and at the base of the projectile. An assumed functional form for the Mach number at the breech provides the necessary boundary condition. Results of the calculation are compared with data obtained from two-stage light gas gun experiments at Oak Ridge National Laboratory for solid deuterium and nylon projectiles with masses ranging from 10 to 35 mg and for projectile speeds between 1.6 and 4.5 km/s. The predicted and measured velocities generally agree to within 15%. 19 refs., 3 figs., 2 tabs

The prognostic value of quantified MRI at an early stage of Bell's palsy

International Nuclear Information System (INIS)

Kress, B.P.J.; Efinger, K.; Gottschalk, A.; Nissen, S.; Solbach, T.; Baehren, W.; Griesbeck, F.; Goriup, A.; Kornhuber, A.W.

2002-01-01

Objective: The aim of the study was to assess whether MRI has a prognostic value at an early stage of Bell's palsy. Material and Methods: Prospective, blinded study on 30 patients suffering from Bell's palsy, who came to hospital until the sixth day of illness, to receive high dosis steroid therapy. MRI was done on the first day of inpatient treatment as a gradient-echo-sequence with a slice thickness of 0.7 mm before and after i.v. administration of 0.1 mmol GdDTPA/kg weight. The signal intensity increase was evaluated quantitatively by region on interest (ROI). The results were compared to the clinical outcome and the results of electrophysiology. Results: The examinations of all patients could be evaluated. The 3 patients who developed a chronic facial paralysis were detected by MRI on the first day of inpatient treatment. The patients, who showed MR signs for an unfavorable course, had a highly significant pathologic compound muscle action potential (CMAP) as a result of the electrophysiologic measurement. Rather than using complex measurement procedures it is possible to obtain reliable prognostic information from just one measurement within the Internal auditory canal before and after i.v. administration of contrast. Conclusion: MRI has a prognostic value at an early stage of the illness. In the clinical setting this measurement is easy to perform, so that it is possible to obtain prognostic information at a stage when causal treatment is still possible. (orig.) [de

Survival Advantage Associated with Decrease in Stage at Detection from Stage IIIC to Stage IIIA Epithelial Ovarian Cancer

Science.gov (United States)

Lefringhouse, Jason; Pavlik, Edward; Miller, Rachel; DeSimone, Christopher; Ueland, Frederick; Kryscio, Richard; van Nagell, J. R.

2014-01-01

Objective. The aim of this study was to document the survival advantage of lowering stage at detection from Stage IIIC to Stage IIIA epithelial ovarian cancer. Methods. Treatment outcomes and survival were evaluated in patients with Stage IIIA and Stage IIIC epithelial ovarian cancer treated from 2000 to 2009 at the University of Kentucky Markey Cancer Center (UKMCC) and SEER institutions. Results. Cytoreduction to no visible disease (P < 0.0001) and complete response to platinum-based chemotherapy (P < 0.025) occurred more frequently in Stage IIIA than in Stage IIIC cases. Time to progression was shorter in patients with Stage IIIC ovarian cancer (17 ± 1 months) than in those with Stage II1A disease (36 ± 8 months). Five-year overall survival (OS) improved from 41% in Stage IIIC patients to 60% in Stage IIIA patients treated at UKMCC and from 37% to 56% in patients treated at SEER institutions for a survival advantage of 19% in both data sets. 53% of Stage IIIA and 14% of Stage IIIC patients had NED at last followup. Conclusions. Decreasing stage at detection from Stage IIIC to stage IIIA epithelial ovarian cancer is associated with a 5-year survival advantage of nearly 20% in patients treated by surgical tumor cytoreduction and platinum-based chemotherapy. PMID:25254047

Design of an electron injector for multi-stages laser wakefield acceleration

International Nuclear Information System (INIS)

Audet, T.

2016-01-01

Laser wakefield acceleration (LWFA) is a particle acceleration process relying on the interaction between high intensity laser pulses, of the order of 10 18 W/cm 2 and a plasma. The plasma wave generated in the laser wake sustain high amplitude electric fields (1- 100 GV/m). Those electric fields are 3 orders of magnitude higher than maximum electric fields in radio frequency cavities and represent the main benefit of LWFA, allowing more compact acceleration. However improvements of the LWFA-produced electron bunches properties, stability and repetition rate are mandatory for LWFA to be usable for applications. A scheme to improve electron bunches properties and to potentially increase the repetition rate is multi-stage LWFA. The laser plasma electron source, called the injector, has to produce relatively low energy (50 - 100 MeV), but high charge, small size and low divergence electron bunches. Produced electron bunches then have to be transported and injected into a second stage to increase electron kinetic energy. The subject of this thesis is to study and design a laser wakefield electron injector for multistage LWFA. In the frame of CILEX and the two-stages LWFA program, a prototype of the injector was built : ELISA consisting in a variable length gas cell. The plasma electronic density, which is a critical parameter for the control of the electron bunches properties, was characterized both experimentally and numerically. ELISA was used at 2 different laser facilities and physical mechanisms linked to electron bunches properties were studied in function of experimental parameters. A range of experimental parameters suitable for a laser wakefield injector was determined. A magnetic transport and diagnostic line was also built, implemented and tested at the UHI100 laser facility of the CEA Saclay. It allowed a more precise characterization of electron bunches generated with ELISA as well as an estimation of the quality of transported electron bunches for their

Characterizing Musculoskeletal Injury among Aeromedical Evacuation Personnel: An Observational Study

Science.gov (United States)

2016-09-28

Jennifer Serres, PhD; Col Susan Dukes, PhD; Molly Wade, MS; Brittany Fouts, MS; Mandy Cowgill, MS; Daniel Pohlman, BS September 2016...CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Jennifer Serres, Susan Dukes, Molly Wade, Brittany Fouts, Mandy... environment . 2.0 INTRODUCTION Musculoskeletal injuries (MSIs) result from the cumulative trauma associated with repetitive and physically

One-stage and two-stage penile buccal mucosa urethroplasty

Directory of Open Access Journals (Sweden)

G. Barbagli

2016-03-01

Full Text Available The paper provides the reader with the detailed description of current techniques of one-stage and two-stage penile buccal mucosa urethroplasty. The paper provides the reader with the preoperative patient evaluation paying attention to the use of diagnostic tools. The one-stage penile urethroplasty using buccal mucosa graft with the application of glue is preliminary showed and discussed. Two-stage penile urethroplasty is then reported. A detailed description of first-stage urethroplasty according Johanson technique is reported. A second-stage urethroplasty using buccal mucosa graft and glue is presented. Finally postoperative course and follow-up are addressed.

Comparison of single-stage and temperature-phased two-stage anaerobic digestion of oily food waste

International Nuclear Information System (INIS)

Wu, Li-Jie; Kobayashi, Takuro; Li, Yu-You; Xu, Kai-Qin

2015-01-01

Highlights: • A single-stage and two two-stage anaerobic systems were synchronously operated. • Similar methane production 0.44 L/g VS_a_d_d_e_d from oily food waste was achieved. • The first stage of the two-stage process became inefficient due to serious pH drop. • Recycle favored the hythan production in the two-stage digestion. • The conversion of unsaturated fatty acids was enhanced by recycle introduction. - Abstract: Anaerobic digestion is an effective technology to recover energy from oily food waste. A single-stage system and temperature-phased two-stage systems with and without recycle for anaerobic digestion of oily food waste were constructed to compare the operation performances. The synchronous operation indicated the similar ability to produce methane in the three systems, with a methane yield of 0.44 L/g VS_a_d_d_e_d. The pH drop to less than 4.0 in the first stage of two-stage system without recycle resulted in poor hydrolysis, and methane or hydrogen was not produced in this stage. Alkalinity supplement from the second stage of two-stage system with recycle improved pH in the first stage to 5.4. Consequently, 35.3% of the particulate COD in the influent was reduced in the first stage of two-stage system with recycle according to a COD mass balance, and hydrogen was produced with a percentage of 31.7%, accordingly. Similar solids and organic matter were removed in the single-stage system and two-stage system without recycle. More lipid degradation and the conversion of long-chain fatty acids were achieved in the single-stage system. Recycling was proved to be effective in promoting the conversion of unsaturated long-chain fatty acids into saturated fatty acids in the two-stage system.

Sentinel node biopsy for early-stage melanoma - Accuracy and morbidity in MSLT-I, an international multicenter trial

NARCIS (Netherlands)

Morton, DL; Cochran, AJ; Thompson, JF; Elashoff, R; Essner, R; Glass, EC; Mozzillo, N; Nieweg, OE; Roses, DF; Hoekstra, HJ; Karakousis, CP; Reintgen, DS; Coventry, BJ; Wang, HJ

Objective:The objective of this study was to evaluate, in an international multicenter phase III trial, the accuracy, use, and morbidity of intraoperative lymphatic mapping and sentinel node biopsy (LM/SNB) for staging the regional nodal basin of patients with early-stage melanoma. Summary

40 CFR 264.554 - Staging piles.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Staging piles. 264.554 Section 264.554... for Cleanup § 264.554 Staging piles. This section is written in a special format to make it easier to... staging pile? A staging pile is an accumulation of solid, non-flowing remediation waste (as defined in...

A stage is a stage is a stage: a direct comparison of two scoring systems.

Science.gov (United States)

Dawson, Theo L

2003-09-01

L. Kohlberg (1969) argued that his moral stages captured a developmental sequence specific to the moral domain. To explore that contention, the author compared stage assignments obtained with the Standard Issue Scoring System (A. Colby & L. Kohlberg, 1987a, 1987b) and those obtained with a generalized content-independent stage-scoring system called the Hierarchical Complexity Scoring System (T. L. Dawson, 2002a), on 637 moral judgment interviews (participants' ages ranged from 5 to 86 years). The correlation between stage scores produced with the 2 systems was .88. Although standard issue scoring and hierarchical complexity scoring often awarded different scores up to Kohlberg's Moral Stage 2/3, from his Moral Stage 3 onward, scores awarded with the two systems predominantly agreed. The author explores the implications for developmental research.

Safety of commercial air travel following myocardial infarction.

Science.gov (United States)

Cox, G R; Peterson, J; Bouchel, L; Delmas, J J

1996-10-01

Travelers occasionally suffer myocardial infarction (MI) while abroad. Existing guidelines recommend a 4- to 24-week convalescent period following MI before air travel should be permitted. Air travel may be undertaken safely in the early post-MI period. The aeromedical transport records of two international medical assistance companies over a 3-yr period were reviewed. We identified 209 patients who suffered MI; 13 transported by private air ambulance were excluded. We reviewed the aeromedical transports of the remaining 196 adults carried on commercial aircraft between 3-53 d post-MI to investigate the safety of air travel in this group. Data were recorded regarding patient age; sex; location of MI; complications of MI; presence of medical escort; duration of flight(s); use of oxygen, medications, or cardiac monitoring during transport; and development of symptoms in flight. Within 7 d of their acute MI 3 patients (2%) were transported; 87 (44%) between days 8-14 post-MI; 65 (33%) between days 15-21; 27 (14%) between days 22-28; and 14 (7%) more than 28 d post-MI. Some 187 patients (95%) were transported without incident; 9 (5%) patients experienced symptoms requiring evaluation by the escorting physician. Of the 9, 6 problems occurred in patients being transported less than 14 d post-MI. Symptoms resolved spontaneously or immediately after physician intervention in all but one case. International aeromedical transport of patients may be safely accomplished 2-3 wk after an acute MI when an accompanying physician is present. Recommendations for delaying travel more than 4 wk after infarction are not supported by clinical experience and should be revised.

Prevalence of Chlorpheniramine in Aviation Accident Pilot Fatalities, 1991-1996

National Research Council Canada - National Science Library

Soper, John

1999-01-01

.... During fatal aircraft accident investigations, postmortem samples collected from the pilots at autopsy are submitted to the Civil Aeromedical Institute for toxicological evaluation, and the findings...

Composers on stage

DEFF Research Database (Denmark)

Groth, Sanne Krogh

A trend on the scene of contemporary music is composers going on stage, performing their pieces themselves. Within a discourse of popular music, this is more the rule than exception, but when it comes to the context of contemporary scored music, the historical and aesthetic context differs......, and something quite different is undergoing. This paper intends to discuss three examples of performances in which the composer’s appearance on stage was an important part of the piece, - both when it came to the role as a performer and as an individual person – as representer and presenter. The paper intends...

Interconnected Levels of Multi-Stage Marketing

DEFF Research Database (Denmark)

Vedel, Mette; Geersbro, Jens; Ritter, Thomas

2012-01-01

different levels of multi-stage marketing and illustrates these stages with a case study. In addition, a triadic perspective is introduced as an analytical tool for multi-stage marketing research. The results from the case study indicate that multi-stage marketing exists on different levels. Thus, managers...... must not only decide in general on the merits of multi-stage marketing for their firm, but must also decide on which level they will engage in multi-stage marketing. The triadic perspective enables a rich and multi-dimensional understanding of how different business relationships influence each other...... in a multi-stage marketing context. This understanding assists managers in assessing and balancing different aspects of multi- stage marketing. The triadic perspective also offers avenues for further research....

Treatment Trends for Stage I Testicular Seminoma in an Equal-Access Medical System.

Science.gov (United States)

Wingate, Jonathan T; Etzioni, Ruth; Macdonald, Dusten M; Brand, Timothy C

2016-10-01

The practice patterns for adjuvant therapies for stage I seminoma are rapidly evolving, and surveillance is currently preferred. How these recommendations have affected contemporary practice in an equal-access US population is unknown. A total of 436 men diagnosed with clinical stage IA-IB seminoma from 2001 to 2011 were identified in the Automated Central Tumor Registry (ACTUR). The ACTUR is the cancer registry system for the Department of Defense. Logistic regression models analyzed the association between patient characteristics and adjuvant therapy. Overall and recurrence-free survival were determined from Kaplan-Meier analysis. The use of adjuvant radiotherapy in this population decreased significantly from 2001 to 2011. In 2001, 83.9% of patients received radiotherapy compared with only 24.0% in 2011. During that period, a concomitant increase occurred in the use of chemotherapy from 0% to 38.0%. A later year of diagnosis was significantly associated with a greater rate of receiving chemotherapy relative to radiotherapy (P associated with the receipt of surveillance (P = .412 for 2006-2011 vs. 2001-2005; odds ratio, 0.83; 95% CI, 0.54-1.29). Black race or age was not significantly associated with adjuvant therapy. With a median follow-up period of 4.7 years, the 5-year overall and recurrence-free survival rates were 98.0% and 77.0%, respectively. The use of adjuvant radiotherapy has been replaced by chemotherapy for clinical stage I testicular seminoma in an equal-access system. The lack of an increase in active surveillance in our cohort might represent overtreatment of the population. Published by Elsevier Inc.

Cochliomyia Homnivorax in an advanced stage in the oral cavity

Directory of Open Access Journals (Sweden)

Layla Gomes

Full Text Available Myiasis is characterized by the invasion of body or cavity tissues of live animals by larva. It is most frequently observed in underdeveloped and tropical countries, but there are cases described worldwide. Conventional treatment consists of mechanical removal of the larvae, one by one, which is a painful, embarrassing and repugnant process, both for the professional and patient. Although it is not considered rare, it has been observed that the dental professional has little knowledge for the diagnosis and treatment of this pathology. For this reason, this study reports a case of oral myiasis at an advanced stage, which affected a nine-year-old patient, treated at a medical-dental clinic. Diagnosis was based on the visual presence of Cochliomyia homnivorax larvae, diptera of the Calliphoridae family, which were between the second and third stages of development. Predisposing factors, such as the lack of information, malnutrition, poor oral hygiene, preexistenceof oral lesions and severe halitosis have a decisive influence in the appearance and progression of oral myiasis. A brief literaturereview was also conducted, in which this pathology was discussed, including the importance of early clinical diagnosis, its etiology, possible associations with other pathologies, and different types of treatment.

Stage-dependent alterations of progenitor cell proliferation and neurogenesis in an animal model of Wernicke-Korsakoff syndrome.

Science.gov (United States)

Vetreno, Ryan P; Klintsova, Anna; Savage, Lisa M

2011-05-19

Alcohol-induced Wernicke-Korsakoff syndrome (WKS) culminates in bilateral diencephalic lesion and severe amnesia. Using the pyrithiamine-induced thiamine deficiency (PTD) animal paradigm of WKS, our laboratory has demonstrated hippocampal dysfunction in the absence of gross anatomical pathology. Extensive literature has revealed reduced hippocampal neurogenesis following a neuropathological insult, which might contribute to hippocampus-based learning and memory impairments. Thus, the current investigation was conducted to determine whether PTD treatment altered hippocampal neurogenesis in a stage-dependent fashion. Male Sprague-Dawley rats were assigned to one of 4 stages of thiamine deficiency based on behavioral symptoms: pre-symptomatic stage, ataxic stage, early post-opisthotonus stage, or the late post-opisthotonus stage. The S-phase mitotic marker 5'-bromo-2'-deoxyuridine (BrdU) was administered at the conclusion of each stage following thiamine restoration and subjects were perfused 24 hours or 28 days after BrdU to assess cellular proliferation or neurogenesis and survival, respectively. Dorsal hippocampal sections were immunostained for BrdU (proliferating cell marker), NeuN (neurons), GFAP (astrocytes), Iba-1 (microglia), and O4 (oligodendrocytes). The PTD treatment increased progenitor cell proliferation and survival during the early post-opisthotonus stage. However, levels of neurogenesis were reduced during this stage as well as the late post-opisthotonus stage where there was also an increase in astrocytogenesis. The diminished numbers of newly generated neurons (BrdU/NeuN co-localization) was paralleled by increased BrdU cells that did not co-localize with any of the phenotypic markers during these later stages. These data demonstrate that long-term alterations in neurogenesis and gliogenesis might contribute to the observed hippocampal dysfunction in the PTD model and human WKS. Published by Elsevier B.V.

Method and system for dual resolution translation stage

Science.gov (United States)

Halpin, John Michael

2014-04-22

A dual resolution translation stage includes a stage assembly operable to receive an optical element and a low resolution adjustment device mechanically coupled to the stage assembly. The dual resolution stage also includes an adjustable pivot block mechanically coupled to the stage assembly. The adjustable pivot block includes a pivot shaft. The dual resolution stage further includes a lever arm mechanically coupled to the adjustable pivot block. The lever arm is operable to pivot about the pivot shaft. The dual resolution stage additionally includes a high resolution adjustment device mechanically coupled to the lever arm and the stage assembly.

Cancer of the Esophagus and Esophagogastric Junction: An Eighth Edition Staging Primer

Science.gov (United States)

Rice, Thomas W.; Ishwaran, Hemant; Ferguson, Mark K.; Blackstone, Eugene H.; Goldstraw, Peter

2017-01-01

This primer for eighth edition staging of esophageal and esophagogastric epithelial cancers presents separate classifications for the clinical (cTNM), pathologic (pTNM), and postneoadjuvant pathologic (ypTNM) stage groups, which are no longer shared. For pTNM, pT1 has been subcategorized as pT1a and pT1b for the subgrouping pStage I adenocarcinoma and squamous cell carcinoma. A new, simplified esophagus-specific regional lymph node map has been introduced. Undifferentiated histologic grade (G4) has been eliminated; additional analysis is required to expose histopathologic cell type. Location has been removed as a category for pT2N0M0 squamous cell cancer. The definition of the esophagogastric junction has been revised. ypTNM stage groups are identical for both histopathologic cell types, unlike those for cTNM and pTNM. PMID:27810391

Falls and Fall Prevention in Older Adults With Early-Stage Dementia: An Integrative Review.

Science.gov (United States)

Lach, Helen W; Harrison, Barbara E; Phongphanngam, Sutthida

2017-05-01

Older adults with mild cognitive impairment (MCI) and early-stage dementia have an increased risk of falling, with risks to their health and quality of life. The purpose of the current integrative review was to evaluate evidence on fall risk and fall prevention in this population. Studies were included if they examined falls or fall risk factors in older adults with MCI or early-stage dementia, or reported interventions in this population; 40 studies met criteria. Evidence supports the increased risk of falls in individuals even in the early stages of dementia or MCI, and changes in gait, balance, and fear of falling that may be related to this increased fall risk. Interventions included exercise and multifactorial interventions that demonstrated some potential to reduce falls in this population. Few studies had strong designs to provide evidence for recommendations. Further study in this area is warranted. [Res Gerontol Nurs. 2017; 10(03):139-148.]. Copyright 2016, SLACK Incorporated.

Effect of ammoniacal nitrogen on one-stage and two-stage anaerobic digestion of food waste

International Nuclear Information System (INIS)

Ariunbaatar, Javkhlan; Scotto Di Perta, Ester; Panico, Antonio; Frunzo, Luigi; Esposito, Giovanni; Lens, Piet N.L.; Pirozzi, Francesco

2015-01-01

Highlights: • Almost 100% of the biomethane potential of food waste was recovered during AD in a two-stage CSTR. • Recirculation of the liquid fraction of the digestate provided the necessary buffer in the AD reactors. • A higher OLR (0.9 gVS/L·d) led to higher accumulation of TAN, which caused more toxicity. • A two-stage reactor is more sensitive to elevated concentrations of ammonia. • The IC 50 of TAN for the AD of food waste amounts to 3.8 g/L. - Abstract: This research compares the operation of one-stage and two-stage anaerobic continuously stirred tank reactor (CSTR) systems fed semi-continuously with food waste. The main purpose was to investigate the effects of ammoniacal nitrogen on the anaerobic digestion process. The two-stage system gave more reliable operation compared to one-stage due to: (i) a better pH self-adjusting capacity; (ii) a higher resistance to organic loading shocks; and (iii) a higher conversion rate of organic substrate to biomethane. Also a small amount of biohydrogen was detected from the first stage of the two-stage reactor making this system attractive for biohythane production. As the digestate contains ammoniacal nitrogen, re-circulating it provided the necessary alkalinity in the systems, thus preventing an eventual failure by volatile fatty acids (VFA) accumulation. However, re-circulation also resulted in an ammonium accumulation, yielding a lower biomethane production. Based on the batch experimental results the 50% inhibitory concentration of total ammoniacal nitrogen on the methanogenic activities was calculated as 3.8 g/L, corresponding to 146 mg/L free ammonia for the inoculum used for this research. The two-stage system was affected by the inhibition more than the one-stage system, as it requires less alkalinity and the physically separated methanogens are more sensitive to inhibitory factors, such as ammonium and propionic acid

An RF power amplifier with inter-metal-shuffled capacitor for inter-stage matching in a digital CMOS process

Energy Technology Data Exchange (ETDEWEB)

Feng Xiaoxing; Zhang Xing; Ge Binjie; Wang Xin' an, E-mail: wangxa@szpku.edu.c [Key Laboratory of Integrated Microsystems, Shenzhen Graduate School of Peking University, Shenzhen 518055 (China)

2009-06-01

One challenge of the implementation of fully-integrated RF power amplifiers into a deep submicro digital CMOS process is that no capacitor is available, especially no high density capacitor. To address this problem, a two-stage class-AB power amplifier with inter-stage matching realized by an inter-metal coupling capacitor is designed in a 180-nm digital CMOS process. This paper compares three structures of inter-metal coupling capacitors with metal-insulator-metal (MIM) capacitor regarding their capacitor density. Detailed simulations are carried out for the leakage, the voltage dependency, the temperature dependency, and the quality factor between an inter-metal shuffled (IMS) capacitor and an MIM capacitor. Finally, an IMS capacitor is chosen to perform the inter-stage matching. The techniques are validated via the design and implement of a two-stage class-AB RF power amplifier for an UHF RFID application. The PA occupies 370 x 200 mum{sup 2} without pads in the 180-nm digital CMOS process and outputs 21.1 dBm with 40% drain efficiency and 28.1 dB power gain at 915 MHz from a single 3.3 V power supply.

An RF power amplifier with inter-metal-shuffled capacitor for inter-stage matching in a digital CMOS process

International Nuclear Information System (INIS)

Feng Xiaoxing; Zhang Xing; Ge Binjie; Wang Xin'an

2009-01-01

One challenge of the implementation of fully-integrated RF power amplifiers into a deep submicro digital CMOS process is that no capacitor is available, especially no high density capacitor. To address this problem, a two-stage class-AB power amplifier with inter-stage matching realized by an inter-metal coupling capacitor is designed in a 180-nm digital CMOS process. This paper compares three structures of inter-metal coupling capacitors with metal-insulator-metal (MIM) capacitor regarding their capacitor density. Detailed simulations are carried out for the leakage, the voltage dependency, the temperature dependency, and the quality factor between an inter-metal shuffled (IMS) capacitor and an MIM capacitor. Finally, an IMS capacitor is chosen to perform the inter-stage matching. The techniques are validated via the design and implement of a two-stage class-AB RF power amplifier for an UHF RFID application. The PA occupies 370 x 200 μm 2 without pads in the 180-nm digital CMOS process and outputs 21.1 dBm with 40% drain efficiency and 28.1 dB power gain at 915 MHz from a single 3.3 V power supply.

Evaluation of occlusal forces in different stages of children - An exploratory study

Directory of Open Access Journals (Sweden)

Priya Subramaniam

2018-01-01

Conclusions: There was a difference in the occlusal bite force at different dentition stages. It was significantly higher in males and in the permanent dentition stage. Height and weight can be considered as predictors of occlusal bite force in older children with permanent dentition.

Imaging and detection of early stage dental caries with an all-optical photoacoustic microscope

International Nuclear Information System (INIS)

Hughes, D A; Kirk, K J; Sampathkumar, A; Longbottom, C

2015-01-01

Tooth decay, at its earliest stages, manifests itself as small, white, subsurface lesions in the enamel. Current methods for detection in the dental clinic are visual and tactile investigations, and bite-wing X-ray radiographs. These techniques suffer from poor sensitivity and specificity at the earliest (and reversible) stages of the disease due to the small size (<100μm) of the lesion. A fine-resolution (600 nm) ultra-broadband (200 MHz) all-optical photoacoustic microscopy system was is used to image the early signs of tooth decay. Ex-vivo tooth samples exhibiting white spot lesions were scanned and were found to generate a larger (one order of magnitude) photoacoustic (PA) signal in the lesion regions compared to healthy enamel. The high contrast in the PA images potentially allows lesions to be imaged and measured at a much earlier stage than current clinical techniques allow. PA images were cross referenced with histology photographs to validate our experimental results. Our PA system provides a noncontact method for early detection of white-spot lesions with a high detection bandwidth that offers advantages over previously demonstrated ultrasound methods. The technique provides the sensing depth of an ultrasound system, but with the spatial resolution of an optical system

The accuracy of Johannesburg-based ambulance personnel in ...

African Journals Online (AJOL)

1 Department of Emergency Medical Care, Faculty of Health Sciences, ... 2 Aeromedical Division, ER24 Emergency Medical Services, Johannesburg, South Africa ..... Facilitating stroke management using modern information technology.

Evaluation of lymph node numbers for adequate staging of Stage II and III colon cancer

Directory of Open Access Journals (Sweden)

Bumpers Harvey L

2011-05-01

Full Text Available Abstract Background Although evaluation of at least 12 lymph nodes (LNs is recommended as the minimum number of nodes required for accurate staging of colon cancer patients, there is disagreement on what constitutes an adequate identification of such LNs. Methods To evaluate the minimum number of LNs for adequate staging of Stage II and III colon cancer, 490 patients were categorized into groups based on 1-6, 7-11, 12-19, and ≥ 20 LNs collected. Results For patients with Stage II or III disease, examination of 12 LNs was not significantly associated with recurrence or mortality. For Stage II (HR = 0.33; 95% CI, 0.12-0.91, but not for Stage III patients (HR = 1.59; 95% CI, 0.54-4.64, examination of ≥20 LNs was associated with a reduced risk of recurrence within 2 years. However, examination of ≥20 LNs had a 55% (Stage II, HR = 0.45; 95% CI, 0.23-0.87 and a 31% (Stage III, HR = 0.69; 95% CI, 0.38-1.26 decreased risk of mortality, respectively. For each six additional LNs examined from Stage III patients, there was a 19% increased probability of finding a positive LN (parameter estimate = 0.18510, p Conclusions Thus, the 12 LN cut-off point cannot be supported as requisite in determining adequate staging of colon cancer based on current data. However, a minimum of 6 LNs should be examined for adequate staging of Stage II and III colon cancer patients.

Staging Mobilities

DEFF Research Database (Denmark)

Jensen, Ole B.

and lived as people are “staging themselves” (from below). Staging mobilities is a dynamic process between “being staged” (for example, being stopped at traffic lights) and the “mobile staging” of interacting individuals (negotiating a passage on the pavement). Staging Mobilities is about the fact...

Development of an innovative two-stage process, a combination of acidogenic hydrogenesis and methanogenesis

Energy Technology Data Exchange (ETDEWEB)

Han, S.K.; Shin, H.S. [Korea Advanced Inst. of Science and Technology, Daejeon (Korea, Republic of). Dept. of Civil and Enviromental Engineering

2004-07-01

Hydrogen produced from waste by means of fermentative bacteria is an attractive way to produce this fuel as an alternative to fossil fuels. It also helps treat the associated waste. The authors have undertaken to optimize acidogenic hydrogenesis and methanogenesis. Building on this, they then developed a two-stage process that produces both hydrogen and methane. Acidogenic hydrogenesis of food waste was investigated using a leaching bed reactor. The dilution rate was varied in order to maximize efficiency which was as high as 70.8 per cent. Further to this, an upflow anaerobic sludge blanket reactor converted the wastewater from acidogenic hydrogenesis into methane. Chemical oxygen demand (COD) removal rates exceeded 96 per cent up to a COD loading of 12.9 COD/l/d. After this, the authors devised a new two-stage process based on a combination of acidogenic hydrogenesis and methanogenesis. The authors report on results for this process using food waste as feedstock. 5 refs., 5 figs.

Developing an inventor support service which performs early stage market and manufacturing evaluations. Final report

Energy Technology Data Exchange (ETDEWEB)

1991-10-01

American businesses are learning the difficult high cost lesson of ignoring production and market factors (producibility, unit product cost (UPC), marketability, etc) during the engineering design phase of product development. Studies have shown that the Japanese spend three times as long as Americans in the design feasibility and decision process of new product introductions and one third the amount of time in the implementation of those products. There is a 20 to 1 cost benefit on effort applied in the design phase versus the production phase of the product life cycle. The number one goal of this project was to establish an organization that has, as one of its purposes, the providing of services responsive to the needs of independent inventors. The number two goal was to demonstrate the value of providing marketing and manufacturing counsel at an early stage in the product development process. The first study goal was met by providing the materials and information necessary to establish an evaluation team and an organization to handle such evaluations. The second study goal was met by demonstrating the impact of early market analysis and manufacturing considerations on product design and therefore on the description of the invention for four different inventions. These inventions were selected at various stages of development. Regardless of stage of development, the marketing and manufacturing reviews resulted in significant changes in design and/or market positioning.

Developing an inventor support service which performs early stage market and manufacturing evaluations. [Final Report

Energy Technology Data Exchange (ETDEWEB)

1991-10-01

American businesses are learning the difficult high cost lesson of ignoring production and market factors (producibility, unit product cost (UPC), marketability, etc) during the engineering design phase of product development. Studies have shown that the Japanese spend three times as long as Americans in the design feasibility and decision process of new product introductions and one third the amount of time in the implementation of those products. There is a 20 to 1 cost benefit on effort applied in the design phase versus the production phase of the product life cycle. The number one goal of this project was to establish an organization that has, as one of its purposes, the providing of services responsive to the needs of independent inventors. The number two goal was to demonstrate the value of providing marketing and manufacturing counsel at an early stage in the product development process. The first study goal was met by providing the materials and information necessary to establish an evaluation team and an organization to handle such evaluations. The second study goal was met by demonstrating the impact of early market analysis and manufacturing considerations on product design and therefore on the description of the invention for four different inventions. These inventions were selected at various stages of development. Regardless of stage of development, the marketing and manufacturing reviews resulted in significant changes in design and/or market positioning.

Mechanisms of stage-transcending protection following immunization of mice with late liver stage-arresting genetically attenuated malaria parasites.

Directory of Open Access Journals (Sweden)

Brandon K Sack

2015-05-01

Full Text Available Malaria, caused by Plasmodium parasite infection, continues to be one of the leading causes of worldwide morbidity and mortality. Development of an effective vaccine has been encumbered by the complex life cycle of the parasite that has distinct pre-erythrocytic and erythrocytic stages of infection in the mammalian host. Historically, malaria vaccine development efforts have targeted each stage in isolation. An ideal vaccine, however, would target multiple life cycle stages with multiple arms of the immune system and be capable of eliminating initial infection in the liver, the subsequent blood stage infection, and would prevent further parasite transmission. We have previously shown that immunization of mice with Plasmodium yoelii genetically attenuated parasites (GAP that arrest late in liver stage development elicits stage-transcending protection against both a sporozoite challenge and a direct blood stage challenge. Here, we show that this immunization strategy engenders both T- and B-cell responses that are essential for stage-transcending protection, but the relative importance of each is determined by the host genetic background. Furthermore, potent anti-blood stage antibodies elicited after GAP immunization rely heavily on FC-mediated functions including complement fixation and FC receptor binding. These protective antibodies recognize the merozoite surface but do not appear to recognize the immunodominant merozoite surface protein-1. The antigen(s targeted by stage-transcending immunity are present in both the late liver stages and blood stage parasites. The data clearly show that GAP-engendered protective immune responses can target shared antigens of pre-erythrocytic and erythrocytic parasite life cycle stages. As such, this model constitutes a powerful tool to identify novel, protective and stage-transcending T and B cell targets for incorporation into a multi-stage subunit vaccine.

A review of the stages of work hardening

Energy Technology Data Exchange (ETDEWEB)

Rollett, A.D.; Kocks, U.F.

1993-07-01

Stages of work hardening are reviewed with emphasis on links between each stage. Simple quantitative descriptions are given for each stage. Similarities between stage I, easy glide, and stage IV, large strain hardening, are pointed out both in terms of magnitude of the hardening rate and of the underlying mechanism of dislocation debris accumulation. Stage II is described as an athermal hardening stage that occurs when statistical variations in the dislocation ``forest`` lead to geometrical storage of dislocations. The steadily decreasing hardening rate observed in stage III is characterized by the increasing rate of loss of dislocation density due to dynamic recovery. Stage III appears to have an asymptote to a saturation stress which is determined by the characteristics of the dislocation tangles, or cell walls. The imperfect nature of the dynamic recovery process, however, leads to the accumulation of dislocation debris and this, by analogy with stage 1, causes the apparent saturation stress to rise, thus causing stage IV.

Trading stages

DEFF Research Database (Denmark)

Steiner, Uli; Tuljapurkar, Shripad; Coulson, Tim

2012-01-01

Interest in stage-and age structured models has recently increased because they can describe quantitative traits such as size that are left out of age-only demography. Available methods for the analysis of effects of vital rates on lifespan in stage-structured models have not been widely applied ...... examples. Much of our approach relies on trading of time and mortality risk in one stage for time and risk in others. Our approach contributes to the new framework of the study of age- and stage-structured biodemography....

Diagnosis and staging of testicular cancer; Diagnostik und Staging von malignen Hodentumoren

Energy Technology Data Exchange (ETDEWEB)

Eiers, Michael; Bender, Karen; Hallscheidt, Peter J. [Universitaetsklinikum Heidelberg (Germany). Abt. Diagnostische und Interventionelle Radiologie

2010-03-15

With an incidence of just 2 % of all maligne tumour diseases testicular cancer is a relative rare tumour disease. In comparison to other tumours, orchiectomy is performed as a first step therapy straight after primary staging which is performed by palpation, ultrasonography and evaluation of the tumour markers. In a second diagnostic step initial staging will be done by re-evaluation of the tumour markers, X-ray of the thorax in some cases also by CT, CT of the abdomen/pelvis or MRI of the abdomen, in progressive disease additional MRI of the head. Follow-up after curative therapy will be performed according to the histological type (seminoma - non-seminoma) and tumour staging. (orig.)

One-Stage Cleft Lip and Palate Repair in an Older Population.

Science.gov (United States)

Guneren, Ethem; Canter, Halil Ibrahim; Yildiz, Kemalettin; Kayan, Resit Burak; Ozpur, Mustafa Aykut; Baygol, Emre Gonenc; Sagir, Haci Omer; Kuzu, Ismail Melih; Akman, Onur; Arslan, Serap

2015-07-01

In underdeveloped countries one-stage definitive repair of cleft lip and palate is considered for late-presenting patients. A total of 25 patients with unoperated cleft lip and palate more than 2 years of age were enrolled in this study for one-stage simultaneous repair of cleft lip and palate. According to Veau-Wardill-Kilner push-back technique, 2 flap palatoplasties were performed for palatal repairs; all of the lips were repaired with the Millard II rotation-advancement technique. The authors experienced no perioperative or postoperative life-threatening complications. With respect to the registered operation periods, longer times were required to perform these double operations, but this elongation is shorter than the sum of the periods if the 2 operations had been performed separately. Although the authors were unable to evaluate the late postoperative results because the authors could not follow-up the patients after they were discharged the day after surgery, the early results related to the success of the operation without any surgical complication were prone to meet the parents' and patients' expectations. The authors presented their experiences with many volunteer cleft lip and palate trips to third world countries; however the structure of this article is not a new hypothesis and data based to support a scientific study, but observations are objective to get a conclusion. To perform one-stage definitive repair of the cleft lip and palate in late-presented patients was the reality that they had only 1 chance to undergo these operations. According to the terms and conditions of this challenging operation, one-stage simultaneous repair of cleft lip and palate is a more demanding and time-consuming procedure than is isolated cleft lip repair or cleft palate repair. Although technically challenging, single-stage repair of the whole deformity in late-presenting patients is a feasible, reliable, successful, and safe procedure in authors' experience.

Kinetic Energy Losses and Efficiency of an Axial Turbine Stage in Numerical Modeling of Unsteady Flows

Directory of Open Access Journals (Sweden)

A. S. Laskin

2015-01-01

Full Text Available The article presents the results of numerical investigation of kinetic energy (KE loss and blading efficiency of the single-stage axial turbine under different operating conditions, characterized by the ratio u/C0. The calculations are performed by stationary (Stage method and nonstationary (Transient method methods using ANSYS CFX. The novelty of this work lies in the fact that the numerical simulation of steady and unsteady flows in a turbine stage is conducted, and the results are obtained to determine the loss of KE, both separately by the elements of the flow range and their total values, in the stage efficiency as well. The results obtained are compared with the calculated efficiency according to one-dimensional theory.To solve these problems was selected model of axial turbine stage with D/l = 13, blade profiles of rotor and stator of constant cross-section, similar to tested ones in inverted turbine when = 0.3. The degree of reactivity ρ = 0.27, the rotor speed was varied within the range 1000 ÷ 1800 rev/min.Results obtained allow us to draw the following conclusions:1. The level of averaged coefficients of total KE losses in the range of from 0.48 to 0.75 is from 18% to 21% when calculating by the Stage method and from 21% to 25% by the Transient one.2. The level of averaged coefficients of KE losses with the output speed of in the specified range is from 9% to 13%, and almost the same when in calculating by Stage and Transient methods.3. Levels of averaged coefficients of KE loss in blade tips (relative to the differential enthalpies per stage are changed in the range: from 4% to 3% (Stage and are stored to be equal to 5% (Transient; from 5% to 6% (Stage and from 6% to 8% (Transient.4. Coefficients of KE losses in blade tips GV and RB are higher in calculations of the model stage using the Transient method than the Stage one, respectively, by = 1.5 ÷ 2.5% and = 4 ÷ 5% of the absolute values. These are values to characterize the KE

Early stages of technology intensive companies

OpenAIRE

Muhos, M. (Matti)

2011-01-01

Abstract This study aims to clarify the early development stages of technology intensive companies. The current literature does not offer an extensive review of stage perspectives for company growth – the overall picture of the field is somewhat vague. The evolution of this field remains unclear as well as the current state. Further, recent empirical stage models focusing on technology intensive companies have not been delineated. As companies move through their early stages, they face ev...

Effect of ammoniacal nitrogen on one-stage and two-stage anaerobic digestion of food waste

Energy Technology Data Exchange (ETDEWEB)

Ariunbaatar, Javkhlan, E-mail: jaka@unicas.it [Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Via Di Biasio 43, 03043 Cassino, FR (Italy); UNESCO-IHE Institute for Water Education, Westvest 7, 2611 AX Delft (Netherlands); Scotto Di Perta, Ester [Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125 Naples (Italy); Panico, Antonio [Telematic University PEGASO, Piazza Trieste e Trento, 48, 80132 Naples (Italy); Frunzo, Luigi [Department of Mathematics and Applications Renato Caccioppoli, University of Naples Federico II, Via Claudio, 21, 80125 Naples (Italy); Esposito, Giovanni [Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Via Di Biasio 43, 03043 Cassino, FR (Italy); Lens, Piet N.L. [UNESCO-IHE Institute for Water Education, Westvest 7, 2611 AX Delft (Netherlands); Pirozzi, Francesco [Department of Civil, Architectural and Environmental Engineering, University of Naples Federico II, Via Claudio 21, 80125 Naples (Italy)

2015-04-15

Highlights: • Almost 100% of the biomethane potential of food waste was recovered during AD in a two-stage CSTR. • Recirculation of the liquid fraction of the digestate provided the necessary buffer in the AD reactors. • A higher OLR (0.9 gVS/L·d) led to higher accumulation of TAN, which caused more toxicity. • A two-stage reactor is more sensitive to elevated concentrations of ammonia. • The IC{sub 50} of TAN for the AD of food waste amounts to 3.8 g/L. - Abstract: This research compares the operation of one-stage and two-stage anaerobic continuously stirred tank reactor (CSTR) systems fed semi-continuously with food waste. The main purpose was to investigate the effects of ammoniacal nitrogen on the anaerobic digestion process. The two-stage system gave more reliable operation compared to one-stage due to: (i) a better pH self-adjusting capacity; (ii) a higher resistance to organic loading shocks; and (iii) a higher conversion rate of organic substrate to biomethane. Also a small amount of biohydrogen was detected from the first stage of the two-stage reactor making this system attractive for biohythane production. As the digestate contains ammoniacal nitrogen, re-circulating it provided the necessary alkalinity in the systems, thus preventing an eventual failure by volatile fatty acids (VFA) accumulation. However, re-circulation also resulted in an ammonium accumulation, yielding a lower biomethane production. Based on the batch experimental results the 50% inhibitory concentration of total ammoniacal nitrogen on the methanogenic activities was calculated as 3.8 g/L, corresponding to 146 mg/L free ammonia for the inoculum used for this research. The two-stage system was affected by the inhibition more than the one-stage system, as it requires less alkalinity and the physically separated methanogens are more sensitive to inhibitory factors, such as ammonium and propionic acid.

Simultaneous versus sequential pharmacokinetic-pharmacodynamic population analysis using an iterative two-stage Bayesian technique

NARCIS (Netherlands)

Proost, Johannes H.; Schiere, Sjouke; Eleveld, Douglas J.; Wierda, J. Mark K. H.

A method for simultaneous pharmacokinetic-pharmacodynamic (PK-PD) population analysis using an Iterative Two-Stage Bayesian (ITSB) algorithm was developed. The method was evaluated using clinical data and Monte Carlo simulations. Data from a clinical study with rocuronium in nine anesthetized

Measurement of the human esophageal cancer in an early stage with Raman spectroscopy

Science.gov (United States)

Maeda, Yasuhiro; Ishigaki, Mika; Taketani, Akinori; Andriana, Bibin B.; Ishihara, Ryu; Sato, Hidetoshi

2014-02-01

The esophageal cancer has a tendency to transfer to another part of the body and the surgical operation itself sometimes gives high risk in vital function because many delicate organs exist near the esophagus. So the esophageal cancer is a disease with a high mortality. So, in order to lead a higher survival rate five years after the cancer's treatment, the investigation of the diagnosis methods or techniques of the cancer in an early stage and support the therapy are required. In this study, we performed the ex vivo experiments to obtain the Raman spectra from normal and early-stage tumor (stage-0) human esophageal sample by using Raman spectroscopy. The Raman spectra are collected by the homemade Raman spectrometer with the wavelength of 785 nm and Raman probe with 600-um-diameter. The principal component analysis (PCA) is performed after collection of spectra to recognize which materials changed in normal part and cancerous pert. After that, the linear discriminant analysis (LDA) is performed to predict the tissue type. The result of PCA indicates that the tumor tissue is associated with a decrease in tryptophan concentration. Furthermore, we can predict the tissue type with 80% accuracy by LDA which model is made by tryptophan bands.

Staging of lung cancer.

Science.gov (United States)

de Groot, Patricia M; Carter, Brett W; Betancourt Cuellar, Sonia L; Erasmus, Jeremy J

2015-06-01

Primary lung cancer is the leading cause of cancer mortality in the world. Thorough clinical staging of patients with lung cancer is important, because therapeutic options and management are to a considerable degree dependent on stage at presentation. Radiologic imaging is an essential component of clinical staging, including chest radiography in some cases, computed tomography, MRI, and PET. Multiplanar imaging modalities allow assessment of features that are important for surgical, oncologic, and radiation therapy planning, including size of the primary tumor, location and relationship to normal anatomic structures in the thorax, and existence of nodal and/or metastatic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

Formative Evaluation of the MENTOR 2010 Courseware

National Research Council Canada - National Science Library

Wenzel, Brenda M; Christinaz, Daniel U; Kretschmer, Monika G; Escobar, Susan L; Garcia, Veronica

2002-01-01

.... Training were measured as increases in scores on achievement tests, increases in self-ratings of levels of knowledge and confidence in specific areas of nursing assessment and aeromedical evacuation(AE...

One-stage or multi-stage creep fatigue behaviour of heat-resistant steels

International Nuclear Information System (INIS)

Kloos, K.H.; Granacher, J.; Scholz, A.

1994-01-01

For one stage realistic long term alternating strain tests on two forged steels with the duration of tests up to an order of magnitude of 45,000 hours, the generalised damage accumulation rule, using an optimised evaluation process dealing with pre-stress effects leads to a relative creep fatigue service life of one. A replacement description by the modified service life share rule is indicated for the long term area. First results from realistic three step tests are classified in the scatter band of single stage stress, where there are only slight differences from different cycle counting processes. (orig.) [de

Modelling of an air-cooled two-stage Rankine cycle for electricity production

International Nuclear Information System (INIS)

Liu, Bo

2014-01-01

This work considers a two stage Rankine cycle architecture slightly different from a standard Rankine cycle for electricity generation. Instead of expanding the steam to extremely low pressure, the vapor leaves the turbine at a higher pressure then having a much smaller specific volume. It is thus possible to greatly reduce the size of the steam turbine. The remaining energy is recovered by a bottoming cycle using a working fluid which has a much higher density than the water steam. Thus, the turbines and heat exchangers are more compact; the turbine exhaust velocity loss is lower. This configuration enables to largely reduce the global size of the steam water turbine and facilitate the use of a dry cooling system. The main advantage of such an air cooled two stage Rankine cycle is the possibility to choose the installation site of a large or medium power plant without the need of a large and constantly available water source; in addition, as compared to water cooled cycles, the risk regarding future operations is reduced (climate conditions may affect water availability or temperature, and imply changes in the water supply regulatory rules). The concept has been investigated by EDF R and D. A 22 MW prototype was developed in the 1970's using ammonia as the working fluid of the bottoming cycle for its high density and high latent heat. However, this fluid is toxic. In order to search more suitable working fluids for the two stage Rankine cycle application and to identify the optimal cycle configuration, we have established a working fluid selection methodology. Some potential candidates have been identified. We have evaluated the performances of the two stage Rankine cycles operating with different working fluids in both design and off design conditions. For the most acceptable working fluids, components of the cycle have been sized. The power plant concept can then be evaluated on a life cycle cost basis. (author)

An automated technique to stage lower third molar development on panoramic radiographs for age estimation: a pilot study.

Science.gov (United States)

De Tobel, J; Radesh, P; Vandermeulen, D; Thevissen, P W

2017-12-01

Automated methods to evaluate growth of hand and wrist bones on radiographs and magnetic resonance imaging have been developed. They can be applied to estimate age in children and subadults. Automated methods require the software to (1) recognise the region of interest in the image(s), (2) evaluate the degree of development and (3) correlate this to the age of the subject based on a reference population. For age estimation based on third molars an automated method for step (1) has been presented for 3D magnetic resonance imaging and is currently being optimised (Unterpirker et al. 2015). To develop an automated method for step (2) based on lower third molars on panoramic radiographs. A modified Demirjian staging technique including ten developmental stages was developed. Twenty panoramic radiographs per stage per gender were retrospectively selected for FDI element 38. Two observers decided in consensus about the stages. When necessary, a third observer acted as a referee to establish the reference stage for the considered third molar. This set of radiographs was used as training data for machine learning algorithms for automated staging. First, image contrast settings were optimised to evaluate the third molar of interest and a rectangular bounding box was placed around it in a standardised way using Adobe Photoshop CC 2017 software. This bounding box indicated the region of interest for the next step. Second, several machine learning algorithms available in MATLAB R2017a software were applied for automated stage recognition. Third, the classification performance was evaluated in a 5-fold cross-validation scenario, using different validation metrics (accuracy, Rank-N recognition rate, mean absolute difference, linear kappa coefficient). Transfer Learning as a type of Deep Learning Convolutional Neural Network approach outperformed all other tested approaches. Mean accuracy equalled 0.51, mean absolute difference was 0.6 stages and mean linearly weighted kappa was

The Staging of the Turk

DEFF Research Database (Denmark)

Holm, Bent

2013-01-01

An analytical and contextualized presentation of the figure of the Turk on the Danish stage in the 18. century with a specific focus on the interaction between the actual commercial and military circumstances on the one hand and the performative representations on the other hand. How far did the ...... the staged image reflect the actual circumstances and how far was it an internal self-reflection?...

An approach to quantitative sustainability assessment in the early stages of process design.

Science.gov (United States)

Tugnoli, Alessandro; Santarelli, Francesco; Cozzani, Valerio

2008-06-15

A procedure was developed for the quantitative assessment of key performance indicators suitable for the sustainability analysis of alternative processes, mainly addressing the early stages of process design. The methodology was based on the calculation of a set of normalized impact indices allowing a direct comparison of the additional burden of each process alternative on a selected reference area. Innovative reference criteria were developed to compare and aggregate the impact indicators on the basis of the site-specific impact burden and sustainability policy. An aggregation procedure also allows the calculation of overall sustainability performance indicators and of an "impact fingerprint" of each process alternative. The final aim of the method is to support the decision making process during process development, providing a straightforward assessment of the expected sustainability performances. The application of the methodology to case studies concerning alternative waste disposal processes allowed a preliminary screening of the expected critical sustainability impacts of each process. The methodology was shown to provide useful results to address sustainability issues in the early stages of process design.

Stage- vs. Channel-strip Metaphor

DEFF Research Database (Denmark)

Gelineck, Steven; Korsgaard, Dannie Michael; Büchert, Morten

2015-01-01

This study compares the stage metaphor and the channel strip metaphor in terms of performance. Traditionally, music mixing consoles employ a channels strip control metaphor for adjusting parameters such as volume and panning of each track. An alternative control metaphor, the so-called stage meta...... is surprisingly similar and thus we are not able to detect any significant difference in performance between the two interfaces. Qualitative data however, suggests that the stage metaphor is largely favoured for its intuitive interaction - confirming earlier studies....

Performance Characterization of an xy-Stage Applied to Micrometric Laser Direct Writing Lithography

Directory of Open Access Journals (Sweden)

Juan Jaramillo

2017-01-01

Full Text Available This article concerns the characterization of the stability and performance of a motorized stage used in laser direct writing lithography. The system was built from commercial components and commanded by G-code. Measurements use a pseudo-periodic-pattern (PPP observed by a camera and image processing is based on Fourier transform and phase measurement methods. The results report that the built system has a stability against vibrations determined by peak-valley deviations of 65 nm and 26 nm in the x and y directions, respectively, with a standard deviation of 10 nm in both directions. When the xy-stage is in movement, it works with a resolution of 0.36 μm, which is an acceptable value for most of research and development (R and D microtechnology developments in which the typical feature size used is in the micrometer range.

Performance Characterization of an xy-Stage Applied to Micrometric Laser Direct Writing Lithography.

Science.gov (United States)

Jaramillo, Juan; Zarzycki, Artur; Galeano, July; Sandoz, Patrick

2017-01-31

This article concerns the characterization of the stability and performance of a motorized stage used in laser direct writing lithography. The system was built from commercial components and commanded by G-code. Measurements use a pseudo-periodic-pattern (PPP) observed by a camera and image processing is based on Fourier transform and phase measurement methods. The results report that the built system has a stability against vibrations determined by peak-valley deviations of 65 nm and 26 nm in the x and y directions, respectively, with a standard deviation of 10 nm in both directions. When the xy-stage is in movement, it works with a resolution of 0.36 μm, which is an acceptable value for most of research and development (R and D) microtechnology developments in which the typical feature size used is in the micrometer range.

One-stage versus two-stage exchange arthroplasty for infected total knee arthroplasty: a systematic review.

Science.gov (United States)

Nagra, Navraj S; Hamilton, Thomas W; Ganatra, Sameer; Murray, David W; Pandit, Hemant

2016-10-01

Infection complicating total knee arthroplasty (TKA) has serious implications. Traditionally the debate on whether one- or two-stage exchange arthroplasty is the optimum management of infected TKA has favoured two-stage procedures; however, a paradigm shift in opinion is emerging. This study aimed to establish whether current evidence supports one-stage revision for managing infected TKA based on reinfection rates and functional outcomes post-surgery. MEDLINE/PubMed and CENTRAL databases were reviewed for studies that compared one- and two-stage exchange arthroplasty TKA in more than ten patients with a minimum 2-year follow-up. From an initial sample of 796, five cohort studies with a total of 231 patients (46 single-stage/185 two-stage; median patient age 66 years, range 61-71 years) met inclusion criteria. Overall, there were no significant differences in risk of reinfection following one- or two-stage exchange arthroplasty (OR -0.06, 95 % confidence interval -0.13, 0.01). Subgroup analysis revealed that in studies published since 2000, one-stage procedures have a significantly lower reinfection rate. One study investigated functional outcomes and reported that one-stage surgery was associated with superior functional outcomes. Scarcity of data, inconsistent study designs, surgical technique and antibiotic regime disparities limit recommendations that can be made. Recent studies suggest one-stage exchange arthroplasty may provide superior outcomes, including lower reinfection rates and superior function, in select patients. Clinically, for some patients, one-stage exchange arthroplasty may represent optimum treatment; however, patient selection criteria and key components of surgical and post-operative anti-microbial management remain to be defined. III.

Improved design for a low temperature scanning tunneling microscope with an in situ tip treatment stage.

Science.gov (United States)

Kim, J-J; Joo, S H; Lee, K S; Yoo, J H; Park, M S; Kwak, J S; Lee, Jinho

2017-04-01

The Low Temperature Scanning Tunneling Microscope (LT-STM) is an extremely valuable tool not only in surface science but also in condensed matter physics. For years, numerous new ideas have been adopted to perfect LT-STM performances-Ultra-Low Vibration (ULV) laboratory and the rigid STM head design are among them. Here, we present three improvements for the design of the ULV laboratory and the LT-STM: tip treatment stage, sample cleaving stage, and vibration isolation system. The improved tip treatment stage enables us to perform field emission for the purpose of tip treatment in situ without exchanging samples, while our enhanced sample cleaving stage allows us to cleave samples at low temperature in a vacuum without optical access by a simple pressing motion. Our newly designed vibration isolation system provides efficient space usage while maintaining vibration isolation capability. These improvements enhance the quality of spectroscopic imaging experiments that can last for many days and provide increased data yield, which we expect can be indispensable elements in future LT-STM designs.

Comparisons of single-stage and two-stage approaches to genomic selection.

Science.gov (United States)

Schulz-Streeck, Torben; Ogutu, Joseph O; Piepho, Hans-Peter

2013-01-01

Genomic selection (GS) is a method for predicting breeding values of plants or animals using many molecular markers that is commonly implemented in two stages. In plant breeding the first stage usually involves computation of adjusted means for genotypes which are then used to predict genomic breeding values in the second stage. We compared two classical stage-wise approaches, which either ignore or approximate correlations among the means by a diagonal matrix, and a new method, to a single-stage analysis for GS using ridge regression best linear unbiased prediction (RR-BLUP). The new stage-wise method rotates (orthogonalizes) the adjusted means from the first stage before submitting them to the second stage. This makes the errors approximately independently and identically normally distributed, which is a prerequisite for many procedures that are potentially useful for GS such as machine learning methods (e.g. boosting) and regularized regression methods (e.g. lasso). This is illustrated in this paper using componentwise boosting. The componentwise boosting method minimizes squared error loss using least squares and iteratively and automatically selects markers that are most predictive of genomic breeding values. Results are compared with those of RR-BLUP using fivefold cross-validation. The new stage-wise approach with rotated means was slightly more similar to the single-stage analysis than the classical two-stage approaches based on non-rotated means for two unbalanced datasets. This suggests that rotation is a worthwhile pre-processing step in GS for the two-stage approaches for unbalanced datasets. Moreover, the predictive accuracy of stage-wise RR-BLUP was higher (5.0-6.1%) than that of componentwise boosting.

Two-Stage Centrifugal Fan

Science.gov (United States)

Converse, David

2011-01-01

Fan designs are often constrained by envelope, rotational speed, weight, and power. Aerodynamic performance and motor electrical performance are heavily influenced by rotational speed. The fan used in this work is at a practical limit for rotational speed due to motor performance characteristics, and there is no more space available in the packaging for a larger fan. The pressure rise requirements keep growing. The way to ordinarily accommodate a higher DP is to spin faster or grow the fan rotor diameter. The invention is to put two radially oriented stages on a single disk. Flow enters the first stage from the center; energy is imparted to the flow in the first stage blades, the flow is redirected some amount opposite to the direction of rotation in the fixed stators, and more energy is imparted to the flow in the second- stage blades. Without increasing either rotational speed or disk diameter, it is believed that as much as 50 percent more DP can be achieved with this design than with an ordinary, single-stage centrifugal design. This invention is useful primarily for fans having relatively low flow rates with relatively high pressure rise requirements.

Development of an in situ temperature stage for synchrotron X-ray spectromicroscopy

Energy Technology Data Exchange (ETDEWEB)

Chakraborty, R., E-mail: rupak@alum.mit.edu, E-mail: buonassisi@mit.edu; Serdy, J.; Culpepper, M. L.; Buonassisi, T., E-mail: rupak@alum.mit.edu, E-mail: buonassisi@mit.edu [Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States); West, B.; Stuckelberger, M.; Bertoni, M. I. [School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe, Arizona 85287 (United States); Lai, B.; Maser, J. [Advanced Photon Source, Argonne National Laboratory, Argonne, Illinois 60439 (United States)

2015-11-15

In situ characterization of micro- and nanoscale defects in polycrystalline thin-film materials is required to elucidate the physics governing defect formation and evolution during photovoltaic device fabrication and operation. X-ray fluorescence spectromicroscopy is particularly well-suited to study defects in compound semiconductors, as it has a large information depth appropriate to study thick and complex materials, is sensitive to trace amounts of atomic species, and provides quantitative elemental information, non-destructively. Current in situ methods using this technique typically require extensive sample preparation. In this work, we design and build an in situ temperature stage to study defect kinetics in thin-film solar cells under actual processing conditions, requiring minimal sample preparation. Careful selection of construction materials also enables controlled non-oxidizing atmospheres inside the sample chamber such as H{sub 2}Se and H{sub 2}S. Temperature ramp rates of up to 300 °C/min are achieved, with a maximum sample temperature of 600 °C. As a case study, we use the stage for synchrotron X-ray fluorescence spectromicroscopy of CuIn{sub x}Ga{sub 1−x}Se{sub 2} (CIGS) thin-films and demonstrate predictable sample thermal drift for temperatures 25–400 °C, allowing features on the order of the resolution of the measurement technique (125 nm) to be tracked while heating. The stage enables previously unattainable in situ studies of nanoscale defect kinetics under industrially relevant processing conditions, allowing a deeper understanding of the relationship between material processing parameters, materials properties, and device performance.

Comparative assessment of single-stage and two-stage anaerobic digestion for the treatment of thin stillage.

Science.gov (United States)

Nasr, Noha; Elbeshbishy, Elsayed; Hafez, Hisham; Nakhla, George; El Naggar, M Hesham

2012-05-01

A comparative evaluation of single-stage and two-stage anaerobic digestion processes for biomethane and biohydrogen production using thin stillage was performed to assess the impact of separating the acidogenic and methanogenic stages on anaerobic digestion. Thin stillage, the main by-product from ethanol production, was characterized by high total chemical oxygen demand (TCOD) of 122 g/L and total volatile fatty acids (TVFAs) of 12 g/L. A maximum methane yield of 0.33 L CH(4)/gCOD(added) (STP) was achieved in the two-stage process while a single-stage process achieved a maximum yield of only 0.26 L CH(4)/gCOD(added) (STP). The separation of acidification stage increased the TVFAs to TCOD ratio from 10% in the raw thin stillage to 54% due to the conversion of carbohydrates into hydrogen and VFAs. Comparison of the two processes based on energy outcome revealed that an increase of 18.5% in the total energy yield was achieved using two-stage anaerobic digestion. Copyright © 2012 Elsevier Ltd. All rights reserved.

Baton twirling on an international stage

CERN Multimedia

Stephanie McClellan

2013-01-01

There aren’t many people who can throw a baton in the air, do a backhand spring and catch it with the grace of a dancer. Well, Julie Haffner from the CERN Press Office can. Baton twirling started as her hobby but soon became a passion - leading her team to win the International Baton Twirling Cup.    Gex Twirling Club performing their winning number at the 2013 International Baton Twirling Cup. (Image: Véronique Bellour). There is no telling when or where people will find their passion. For Julie Haffner, it was when she followed her cousin to a baton twirling class at the age of 10. Since that fortuitous day, she has committed herself to the sport and competed on international stages. Very close to rhythmic gymnastics, baton twirling requires skilful coordination and teamwork. Julie’s performances combine the precision of baton manipulation, the grace of a dancer and the strength of a gymnast. The first year in which she competed with the Gex Twirlin...

Life stages of an aphid living under similar thermal conditions differ in thermal performance.

Science.gov (United States)

Zhao, Fei; Hoffmann, Ary A; Xing, Kun; Ma, Chun-Sen

2017-05-01

Heat responses can vary ontogenetically in many insects with complex life cycles, reflecting differences in thermal environments they experience. Such variation has rarely been considered in insects that develop incrementally and experience common microclimates across stages. To test if there is a low level of ontogenetic variation for heat responses in one such species, the English grain aphid Sitobion avenae, basal tolerance [upper lethal temperature (ULT 50 ) and maximum critical temperature (CT max )], hardening capacity (CT max ) and hardening costs (adult longevity and fecundity) were measured across five stages (1st, 2nd, 3rd and 4th-instar nymphs and newly moulted adults). We found large tolerance differences among stages of this global pest species, and a tendency for the stage with lower heat tolerance to show a stronger hardening response. There were also substantial reproductive costs of hardening responses, with the level of stress experienced, and not the proximity of the exposed stage to the reproductive adult stage, influencing the magnitude of this cost. Hence hardening in this aphid may counter inherently low tolerance levels of some life stages but at a cost to adult longevity and fecundity. Our findings highlight the significance of ontogenetic variation in predicting responses of a species to climate change, even in species without a complex life cycle. Copyright © 2017 Elsevier Ltd. All rights reserved.

Radical surgery for early stage cervical cancer

NARCIS (Netherlands)

Derks, M.

2017-01-01

Cervical cancer is one of the most common malignancies in women worldwide. Due to an effective screening programme, in the Netherlands cervical cancer is often detected in early stages of disease. For early stage (International Federation of Gynaecology and Obstetrics (FIGO) stage IB/IIA) cervical

An embryonic staging table for in ovo development of Eublepharis macularius, the leopard gecko.

Science.gov (United States)

Wise, Patrick A D; Vickaryous, Matthew K; Russell, Anthony P

2009-08-01

Squamates constitute a major vertebrate radiation, representing almost one-third of all known amniotes. Although speciose and morphologically diverse, they remain poorly represented in developmental studies. Here, we present an embryonic staging table of in ovo development for the basal gekkotan Eublepharis macularius (the leopard gecko) and advocate this species as a laboratory-appropriate developmental model. E. macularius, is a hardy and tractable species of relatively large body size (with concomitantly relatively large eggs and embryos), that is widely available and easy to maintain and propagate. Additionally, E. macularius displays a body plan appropriate to the study of the plesiomorphic quadrupedal condition of early pentadactylous terrestrial amniotes. Although not unexpected, it is worth noting that the morphological events characterizing limb development in E. macularius are comparable with those described for the avian Gallus gallus. Therefore, E. macularius holds great promise as a model for developmental studies focusing on pentadactyly and the formation of digits. Furthermore, it is also attractive as a developmental model because it demonstrates temperature-dependent sex determination. The staging table presented herein is based on an all-female series and represents the entire 52 day in ovo period. Overall, embryogenesis of E. macularius is similar to that of other squamates in terms of developmental stage attained at the time of oviposition, patterns of limb and pharyngeal arch development, and features of the appearance of scalation and pigmentation, indicative of a conserved developmental program. (c) 2009 Wiley-Liss, Inc.

Sleep Stage Transition Dynamics Reveal Specific Stage 2 Vulnerability in Insomnia.

Science.gov (United States)

Wei, Yishul; Colombo, Michele A; Ramautar, Jennifer R; Blanken, Tessa F; van der Werf, Ysbrand D; Spiegelhalder, Kai; Feige, Bernd; Riemann, Dieter; Van Someren, Eus J W

2017-09-01

Objective sleep impairments in insomnia disorder (ID) are insufficiently understood. The present study evaluated whether whole-night sleep stage dynamics derived from polysomnography (PSG) differ between people with ID and matched controls and whether sleep stage dynamic features discriminate them better than conventional sleep parameters. Eighty-eight participants aged 21-70 years, including 46 with ID and 42 age- and sex-matched controls without sleep complaints, were recruited through www.sleepregistry.nl and completed two nights of laboratory PSG. Data of 100 people with ID and 100 age- and sex-matched controls from a previously reported study were used to validate the generalizability of findings. The second night was used to obtain, in addition to conventional sleep parameters, probabilities of transitions between stages and bout duration distributions of each stage. Group differences were evaluated with nonparametric tests. People with ID showed higher empirical probabilities to transition from stage N2 to the lighter sleep stage N1 or wakefulness and a faster decaying stage N2 bout survival function. The increased transition probability from stage N2 to stage N1 discriminated people with ID better than any of their deviations in conventional sleep parameters, including less total sleep time, less sleep efficiency, more stage N1, and more wake after sleep onset. Moreover, adding this transition probability significantly improved the discriminating power of a multiple logistic regression model based on conventional sleep parameters. Quantification of sleep stage dynamics revealed a particular vulnerability of stage N2 in insomnia. The feature characterizes insomnia better than-and independently of-any conventional sleep parameter. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Evaluating Changes In Fertility Status Of An Alfisol Under Different Growth Stages Of Cassava Manihot Esculenta Crantz

Directory of Open Access Journals (Sweden)

B. Osundare

2015-02-01

Full Text Available Abstract Evaluating changes in soil nutrient status under different growth stages of cassava makes possible determination of the most critical stage in its vegetative growth phase when its demand for nutrients is highest. Determining the most critical stage in cassava vegetative growth phase when its nutrient demand is highest will enhance properly timed fertilizer application in such a way the application will coincide with the most critical stage in cassava vegetative phase when its demand for nutrients is highest. In view of this a two year field experiment was designed to assess changes in nutrient status of an Alfisol under different growth stages of cassava during 2010 and 2011 cropping seasons at the Teaching and Research Farm of the Ekiti State University Ado Ekiti Ekiti State Nigeria. The experiment was laid out in a randomized complete block design with three replicates. The different growth stages of cassava when changes in nutrient status of Alfisol were evaluated included 3 6 9 and 12 months after planting MAP. The results indicated existence of significant P 0.05 differences among the different growth stages of cassava as regards their effects on chemical properties of Alfisol. During 2010 cropping season the significant decreases in soil organic carbon SOC under growth stages of cassava were from 0.96 g kg-1 for ISNSPTC to 0.88 0.80 0.72 and0.64 g kg-1 for ages 3 6 9 and 12 MAP respectively. Similarly during 2011 cropping season the significant decreases in soil organic carbon SOC under growth stages of cassava were from 0.96 g kg-1 for ISNSPTC to 0.80 0.73 0.66 and0.58 g kg-1 for ages 3 6 9 and 12 MAP respectively. During 2010 cropping season the significant decreases in total N under growth stages of cassava were from 0.68 g kg-1 for ISNSPTC to 0.57 0.50 0.43 and0.35 g kg-1 for ages 3 6 9 and 12 MAP respectively. During 2011 cropping season the significant decreases in total N under growth stages of cassava were from 0.68 g kg-1

Early stage fuel cell funding

International Nuclear Information System (INIS)

Bergeron, C.

2004-01-01

'Full text:' Early stage venture funding requires an in depth understanding of both current and future markets as well as the key technical hurdles that need to be overcome for new technology to commercialize into successful products for mass markets. As the leading fuel cell and hydrogen investor, Chrysalix continuously reviews global trends and new technologies, evaluates them with industry leaders worldwide and tries to match them up with the best possible management teams when selecting its early stage investments. Chrysalix Energy Limited Partnership is an early-stage venture capital firm focusing on fuel cell and related fueling technology companies and is a private equity joint venture between Ballard Power Systems, BASF Venture Capital, The BOC Group, The Boeing Company, Duke Energy, Mitsubishi Corporation and Shell Hydrogen. Operating independently, Chrysalix offers a unique value proposition to its clients throughout the business planning, start-up and operations phases of development. Chrysalix provides early-stage funding to new companies as well as management assistance, technological knowledge, organized networking with industry players and experience in the management of intellectual property. (author)

Department of Defense Dictionary of Military and Associated Terms

Science.gov (United States)

2016-02-15

via an aeromedical evacuation system or system echelon. (JP 4-02) aeronautical chart — A specialized representation of mapped features of the Earth...blisters the skin. Also called vesicant agent. (JP 3-11) blood agent — A chemical compound, including the cyanide group, that affects bodily functions...combat and operational stress — The expected and predictable emotional , intellectual, physical, and/or behavioral reactions of an individual who has

An integrated multi-stage supply chain inventory model with imperfect production process

Directory of Open Access Journals (Sweden)

Soumita Kundu

2015-09-01

Full Text Available This paper deals with an integrated multi-stage supply chain inventory model with the objective of cost minimization by synchronizing the replenishment decisions for procurement, production and delivery activities. The supply chain structure examined here consists of a single manufacturer with multi-buyer where manufacturer orders a fixed quantity of raw material from outside suppliers, processes the materials and delivers the finished products in unequal shipments to each customer. In this paper, we consider an imperfect production system, which produces defective items randomly and assumes that all defective items could be reworked. A simple algorithm is developed to obtain an optimal production policy, which minimizes the expected average total cost of the integrated production-inventory system.

Rapid Two-stage Versus One-stage Surgical Repair of Interrupted Aortic Arch with Ventricular Septal Defect in Neonates

Directory of Open Access Journals (Sweden)

Meng-Lin Lee

2008-11-01

Conclusion: The outcome of rapid two-stage repair is comparable to that of one-stage repair. Rapid two-stage repair has the advantages of significantly shorter cardiopulmonary bypass duration and AXC time, and avoids deep hypothermic circulatory arrest. LVOTO remains an unresolved issue, and postoperative aortic arch restenosis can be dilated effectively by percutaneous balloon angioplasty.

Hodgkin's disease part 1: pathology, staging, and management of early stage disease

International Nuclear Information System (INIS)

Mauch, Peter; Yahalom, Joachim

1995-01-01

Over the past 25 years there have been dramatic improvements in our understanding of the epidemiology, biology, natural history, and treatment of Hodgkins disease. Hodgkin's disease is one of the few cancers where both chemotherapy and radiation therapy have provided dramatic improvements in cure of this once uniformly fatal disease. Part 1 of the refresher course on Hodgkin's disease will include a review of: 1) New Findings in epidemiology, immunohistochemistry and molecular biology of the Reed-Sternberg cell including association with Epstein-Barr virus; 2) Review of pathology including discussions of NS 1 vs NS2, and nodular LP subclassifications; 3) Recommendations for staging including the role of staging laparotomy in Hodgkin's disease; 4) Standard techniques for commonly used radiation therapy fields for Hodgkin's disease and 5) Treatment of early stage Hodgkin's disease including an overview on recent and current clinical trials

An Economic Analysis of the Aeromedical Evacuation, Patient Movement Items Program

Science.gov (United States)

1999-12-01

contract. The prime vendor option has been utilized to support lower intensity contingency operations, operations other than war and military exercises ...DYSMENORRHEA AMENORRHEA PELVIC INFLAMMATORY DISEASE (PID) ALL CASES CERVICmS ENDOCERVICmS WTTH SYMPTOMATIC LEUKORRHEA VULVOVAGINmS • TUB AL... INDUCED (LASER) SEVERE OF MACULA AND/OR OPTIC NERVE. WTTH VTTREOUS BLOOD. SEVERE VISUAL LOSE, 0 BOTHEYES. 347 EYEWOUND DIRECTED ENERGY INDUCED (LASER

Deployable Oxygen System (DOS)

National Research Council Canada - National Science Library

Robertson, Charles

2001-01-01

...) is designated lead command for Aeromedical Evacuation (AE). As lead command, AMC provides evacuation of sick/injured patients, in peacetime and contingency operations, under the supervision of qualified medical crewmembers via fixed wing aircraft...

Prostate cancer staging

Science.gov (United States)

... this page: //medlineplus.gov/ency/patientinstructions/000397.htm Prostate cancer staging To use the sharing features on this ... trials you may be able to join How Prostate Cancer Staging is Done Initial staging is based on ...

Correlation between chronological age and third molar developmental stages in an Iranian population (Demirjian method).

Science.gov (United States)

Khosronejad, Aria; Navabi, Manijeh; Sakhdari, Shirin; Rakhshan, Vahid

2017-01-01

Third molar development is the only available tool for estimating the age of individuals after puberty. Since this tooth has very high interethnic variability, formulas calculated to estimate the age from its development stages cannot be generalized to other populations and should be adjusted for each region. Therefore, this study was conducted to evaluate this method in a sample of Tehran individuals for the first time, and also to compare the development of third molars across sexes and arches, and to estimate cutoff developmental stages for legal minor/major identification. A total of 150 dental patients aged between 15 and 25 years old were prospectively enrolled, and their Demirjian stages were recorded. The associations between chronological age and Demirjian stages were evaluated. Dental formation was compared between sexes and jaws. Cutoff stages were determined to identify legal minor/major cases (above or below 18 years old). Age estimation formula was found for this population. Of the 150 included patients, 56 were males. The difference between the ages of males and females at each given developmental stage was nonsignificant ( P > 0.05), except for the H stage. Age difference between same stage teeth of the maxilla and mandible was nonsignificant. Each of the G and H stages was significantly above 18 years old ( P age were above 90% (all P Third molar development was positively affected by the chronological age ( P = 0.000) and being maxillary ( P = 0.000) but not sex ( P = 0.113). Regression formula for age estimation was: age = 6.52+ (0.64 × sex) + (0.32 × arch) + (1.86 × Demirjian stage). Development of third molar might complete after the age 22. Iranian individuals with third molars at the G and H stages are likely above 18 while those at E and F are likely below 18. Pace of molar development differs for jaws, but intergender differences are open to further investigations.

STAGE TECHNOLOGY FOR OBTAINIGN AN ECONOMIC WHITE WINE TO AN INDUSTRIAL SCALE

Directory of Open Access Journals (Sweden)

Juan Esteban Miño Valdés

2015-07-01

Full Text Available The purpose of this work was to develop a sustainable technology to produce economical white wine, industrial scale, not viniferous grapes grown in Misiones. This technological project started at laboratory scale, it continued in a pilot plant and planned to an industrial scale. It was considered as productive unit 12 rural families with 27 hectares of vines each. The 8 stages followed with inductive and deductive methodology were: the development of dry white wine at laboratory scale, the evaluation of the variables of the process in the vilification, the Mathematical modeling of alcoholic fermentation in winemaking conditions, the assessment of the fitness of wines for human consumption, the establishment of a technological process for winemaking in a pilot plant, the evaluation in pilot plant of the technological process established, the calculation and selection of industrial equipment and finally, the costs estimation and profitability of the industrial technological process. A technology for a production capacity of 5,834 L day-1, with dynamic economic indicators was reached whose values were 6,602,666 net present value of U$D, an internal rate of return of 60 % for a period of payback a value net of three years to date.

Validity and reliability of an application review process using dedicated reviewers in one stage of a multi-stage admissions model.

Science.gov (United States)

Zeeman, Jacqueline M; McLaughlin, Jacqueline E; Cox, Wendy C

2017-11-01

With increased emphasis placed on non-academic skills in the workplace, a need exists to identify an admissions process that evaluates these skills. This study assessed the validity and reliability of an application review process involving three dedicated application reviewers in a multi-stage admissions model. A multi-stage admissions model was utilized during the 2014-2015 admissions cycle. After advancing through the academic review, each application was independently reviewed by two dedicated application reviewers utilizing a six-construct rubric (written communication, extracurricular and community service activities, leadership experience, pharmacy career appreciation, research experience, and resiliency). Rubric scores were extrapolated to a three-tier ranking to select candidates for on-site interviews. Kappa statistics were used to assess interrater reliability. A three-facet Many-Facet Rasch Model (MFRM) determined reviewer severity, candidate suitability, and rubric construct difficulty. The kappa statistic for candidates' tier rank score (n = 388 candidates) was 0.692 with a perfect agreement frequency of 84.3%. There was substantial interrater reliability between reviewers for the tier ranking (kappa: 0.654-0.710). Highest construct agreement occurred in written communication (kappa: 0.924-0.984). A three-facet MFRM analysis explained 36.9% of variance in the ratings, with 0.06% reflecting application reviewer scoring patterns (i.e., severity or leniency), 22.8% reflecting candidate suitability, and 14.1% reflecting construct difficulty. Utilization of dedicated application reviewers and a defined tiered rubric provided a valid and reliable method to effectively evaluate candidates during the application review process. These analyses provide insight into opportunities for improving the application review process among schools and colleges of pharmacy. Copyright © 2017 Elsevier Inc. All rights reserved.

Apparatus and methods for controlling electron microscope stages

Science.gov (United States)

Duden, Thomas

2015-08-11

Methods and apparatus for generating an image of a specimen with a microscope (e.g., TEM) are disclosed. In one aspect, the microscope may generally include a beam generator, a stage, a detector, and an image generator. A plurality of crystal parameters, which describe a plurality of properties of a crystal sample, are received. In a display associated with the microscope, an interactive control sphere based at least in part on the received crystal parameters and that is rotatable by a user to different sphere orientations is presented. The sphere includes a plurality of stage coordinates that correspond to a plurality of positions of the stage and a plurality of crystallographic pole coordinates that correspond to a plurality of polar orientations of the crystal sample. Movement of the sphere causes movement of the stage, wherein the stage coordinates move in conjunction with the crystallographic coordinates represented by pole positions so as to show a relationship between stage positions and the pole positions.

Use of a two-stage light-gas gun as an injector for electromagnetic railguns

International Nuclear Information System (INIS)

Shahinpoor, M.

1989-01-01

Ablation of wall materials is known to be a major factor limiting the performance of railguns. To minimize this effect, it is desirable too inject projectiles into railgun at velocities greater than the ablation threshold velocity (6-8 km/s for copper rails). Because two-stage light-gas guns are capable of achieving such velocities, a program was initiated to design, build and evaluate the performance of a two-stage light gas gun, utilizing hydrogen gas, for use as an injector to an electromagnetic railgun. This effort is part of a project to develop a hypervelocity electromagnetic launcher (HELEOS) for use in equation-of-state studies. In this paper, the specific design features that enhance compatibility of the injector with the railgun, including a slip-joint between the injector launch tube and the coupling section to the railgun are described. The operational capabilities for using all major projectile velocity measuring techniques, such as in-bore pressure gauges, laser and CW x-ray interrupt techniques, flash x-ray and continuous in-bore velocity measurements using VISAR interferometry are also discussed. Finally an internal ballistics code for optimizing gun performance has been utilized to interpret performance data of the gun

Sensitivity Analysis in Two-Stage DEA

Directory of Open Access Journals (Sweden)

Athena Forghani

2015-07-01

Full Text Available Data envelopment analysis (DEA is a method for measuring the efficiency of peer decision making units (DMUs which uses a set of inputs to produce a set of outputs. In some cases, DMUs have a two-stage structure, in which the first stage utilizes inputs to produce outputs used as the inputs of the second stage to produce final outputs. One important issue in two-stage DEA is the sensitivity of the results of an analysis to perturbations in the data. The current paper looks into combined model for two-stage DEA and applies the sensitivity analysis to DMUs on the entire frontier. In fact, necessary and sufficient conditions for preserving a DMU's efficiency classiffication are developed when various data changes are applied to all DMUs.

Sensitivity Analysis in Two-Stage DEA

Directory of Open Access Journals (Sweden)

Athena Forghani

2015-12-01

Full Text Available Data envelopment analysis (DEA is a method for measuring the efficiency of peer decision making units (DMUs which uses a set of inputs to produce a set of outputs. In some cases, DMUs have a two-stage structure, in which the first stage utilizes inputs to produce outputs used as the inputs of the second stage to produce final outputs. One important issue in two-stage DEA is the sensitivity of the results of an analysis to perturbations in the data. The current paper looks into combined model for two-stage DEA and applies the sensitivity analysis to DMUs on the entire frontier. In fact, necessary and sufficient conditions for preserving a DMU's efficiency classiffication are developed when various data changes are applied to all DMUs.

The cost of unresectable stage III or stage IV melanoma in Italy

Directory of Open Access Journals (Sweden)

Maio Michele

2012-11-01

Full Text Available Abstract Background In recent decades, melanoma incidence has been increasing in European countries; in 2006, there were approximately 60,000 cases leading to 13,000 deaths. Within Europe there is some geographical variation in the incidence of melanoma, with the highest rates reported in Scandinavia (15 cases per 100,000 inhabitants per year and the lowest in the Mediterranean countries (5 to 7 cases per 100,000 inhabitants per year. Methods The present article is based on the information collected in the MELODY study (MELanoma treatment patterns and Outcomes among patients with unresectable stage III or stage IV Disease: a retrospective longitudinal survey. In that study, the medical charts of patients were reviewed to document current treatment patterns and to analyse information on patients, disease characteristics and healthcare resource utilization related to the treatment of advanced melanoma regarding patients who presented with a diagnosis of malignant melanoma (stage I to IV at participating sites between 01 July, 2005 and 30 June, 2006. Results Summarizing, though the length of the follow-up period varies among sample patients, an amount of the yearly cost per patient can be estimated, dividing the average per patient total cost (€ 5.040 by the average follow-up duration (17.5 months and reporting to one year; on these grounds, unresectable stage III or stage IV melanoma in Italy would cost € 3,456 per patient per year.

Current Treatments for Surgically Resectable, Limited-Stage, and Extensive-Stage Small Cell Lung Cancer.

Science.gov (United States)

Stinchcombe, Thomas E

2017-12-01

The prevalence of small cell lung cancer (SCLC) has declined in the U.S. as the prevalence of tobacco use has declined. However, a significant number of people in the U.S. are current or former smokers and are at risk of developing SCLC. Routine histological or cytological evaluation can reliably make the diagnosis of SCLC, and immunohistochemistry stains (thyroid transcription factor-1, chromogranin, synaptophysin, and CD56) can be used if there is uncertainty about the diagnosis. Rarely do patients present with SCLC amendable to surgical resection, and evaluation requires a meticulous workup for extra-thoracic metastases and invasive staging of the mediastinum. Resected patients require adjuvant chemotherapy and/or thoracic radiation therapy (TRT), and prophylactic cranial radiation (PCI) should be considered depending on the stage. For limited-stage disease, concurrent platinum-etoposide and TRT followed by PCI is the standard. Thoracic radiation therapy should be started early in treatment, and can be given twice daily to 45 Gy or once daily to 60-70 Gy. For extensive-stage disease, platinum-etoposide remains the standard first-line therapy, and the standard second-line therapy is topotecan. Preliminary studies have demonstrated the activity of immunotherapy, and the response rate is approximately 10-30% with some durable responses observed. Rovalpituzumab tesirine, an antibody drug conjugate, has shown promising activity in patients with high delta-like protein 3 tumor expression (approximately 70% of patients with SCLC). The emergence of these and other promising agents has rekindled interest in drug development in SCLC. Several ongoing trials are investigating novel agents in the first-line, maintenance, and second-line settings. This review will provide an update on the standard therapies for surgically resected limited-stage small cell lung cancer and extensive-stage small cell lung cancer that have been investigated in recent clinical trials. © Alpha

Numerical simulation of stage separation of a multi-stage flying object with brake jets

International Nuclear Information System (INIS)

Mirzaei, M.; Shadaram, A.; Nia, B.N.

2005-01-01

In this paper, separation maneuver of a two-stage supersonic flying object is numerically simulated and the influences of supersonic brake jets on separation process are discussed. The finite volume approach is used for solution of unsteady three-dimensional full Navier-Stokes equations on a moving boundary domain. In this simulation, air has considered as a calorically perfect gas and since the flow field is turbulent, two equations κ-ε model has been adopted for turbulence modeling. Shocks, expansions and their reflections have major role on flow pattern between two stages during the separation process and the maneuver is dominantly affected by the main flow and braking jets. The separation process has an unsteady nature and the separation of stages at high Mach numbers induces some aerodynamic problems that may lead to fail the next stage flight. The purpose of this research is to compute the aerodynamic loads on separated stage and, consequently, the relative distance of body components with a good accuracy. The simulation of moving boundary problem is based on moving grid strategy using remeshing method. To validate the simulation, some of the results are compared with experimental data. (author)

Optics of two-stage photovoltaic concentrators with dielectric second stages

Science.gov (United States)

Ning, Xiaohui; O'Gallagher, Joseph; Winston, Roland

1987-04-01

Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

Optics of two-stage photovoltaic concentrators with dielectric second stages.

Science.gov (United States)

Ning, X; O'Gallagher, J; Winston, R

1987-04-01

Two-stage photovoltaic concentrators with Fresnel lenses as primaries and dielectric totally internally reflecting nonimaging concentrators as secondaries are discussed. The general design principles of such two-stage systems are given. Their optical properties are studied and analyzed in detail using computer ray trace procedures. It is found that the two-stage concentrator offers not only a higher concentration or increased acceptance angle, but also a more uniform flux distribution on the photovoltaic cell than the point focusing Fresnel lens alone. Experimental measurements with a two-stage prototype module are presented and compared to the analytical predictions.

Two-stage discrete-continuous multi-objective load optimization: An industrial consumer utility approach to demand response

International Nuclear Information System (INIS)

Abdulaal, Ahmed; Moghaddass, Ramin; Asfour, Shihab

2017-01-01

Highlights: •Two-stage model links discrete-optimization to real-time system dynamics operation. •The solutions obtained are non-dominated Pareto optimal solutions. •Computationally efficient GA solver through customized chromosome coding. •Modest to considerable savings are achieved depending on the consumer’s preference. -- Abstract: In the wake of today’s highly dynamic and competitive energy markets, optimal dispatching of energy sources requires effective demand responsiveness. Suppliers have adopted a dynamic pricing strategy in efforts to control the downstream demand. This method however requires consumer awareness, flexibility, and timely responsiveness. While residential activities are more flexible and schedulable, larger commercial consumers remain an obstacle due to the impacts on industrial performance. This paper combines methods from quadratic, stochastic, and evolutionary programming with multi-objective optimization and continuous simulation, to propose a two-stage discrete-continuous multi-objective load optimization (DiCoMoLoOp) autonomous approach for industrial consumer demand response (DR). Stage 1 defines discrete-event load shifting targets. Accordingly, controllable loads are continuously optimized in stage 2 while considering the consumer’s utility. Utility functions, which measure the loads’ time value to the consumer, are derived and weights are assigned through an analytical hierarchy process (AHP). The method is demonstrated for an industrial building model using real data. The proposed method integrates with building energy management system and solves in real-time with autonomous and instantaneous load shifting in the hour-ahead energy price (HAP) market. The simulation shows the occasional existence of multiple load management options on the Pareto frontier. Finally, the computed savings, based on the simulation analysis with real consumption, climate, and price data, ranged from modest to considerable amounts

The protection motivation theory within the stages of the transtheoretical model - stage-specific interplay of variables and prediction of exercise stage transitions.

Science.gov (United States)

Lippke, Sonia; Plotnikoff, Ronald C

2009-05-01

Two different theories of health behaviour have been chosen with the aim of theory integration: a continuous theory (protection motivation theory, PMT) and a stage model (transtheoretical model, TTM). This is the first study to test whether the stages of the TTM moderate the interrelation of PMT-variables and the mediation of motivation, as well as PMT-variables' interactions in predicting stage transitions. Hypotheses were tested regarding (1) mean patterns, stage pair-comparisons and nonlinear trends using ANOVAs; (2) prediction-patterns for the different stage groups employing multi-group structural equation modelling (MSEM) and nested model analyses; and (3) stage transitions using binary logistic regression analyses. Adults (N=1,602) were assessed over a 6 month period on their physical activity stages, PMT-variables and subsequent behaviour. (1) Particular mean differences and nonlinear trends in all test variables were found. (2) The PMT adequately fitted the five stage groups. The MSEM revealed that covariances within threat appraisal and coping appraisal were invariant and all other constrains were stage-specific, i.e. stage was a moderator. Except for self-efficacy, motivation fully mediated the relationship between the social-cognitive variables and behaviour. (3) Predicting stage transitions with the PMT-variables underscored the importance of self-efficacy. Only when threat appraisal and coping appraisal were high, stage movement was more likely in the preparation stage. Results emphasize stage-specific differences of the PMT mechanisms, and hence, support the stage construct. The findings may guide further theory building and research integrating different theoretical approaches.

Design and modelling of an innovative three-stage thermal storage system for direct steam generation CSP plants

Science.gov (United States)

Garcia, Pierre; Vuillerme, Valéry; Olcese, Marco; El Mourchid, Nadim

2016-05-01

Thermal Energy Storage systems (TES) for a Direct Steam Generation (DSG) solar plant feature preferably three stages in series including a latent heat storage module so that steam can be recovered with a limited temperature loss. The storage system designed within the Alsolen Sup project is characterized by an innovative combination of sensible and latent modules. A dynamic model of this three-stage storage has been developed and applied to size the storage system of the Alsolen Sup® plant demonstrator at CEA Cadarache. Results of this simulation show that this promising concept is an efficient way to store heat in DSG solar plants.

Environmental impact of a nuclear industry at an early stage of development: peculiar aspects

International Nuclear Information System (INIS)

Paschoa, A.S.; Baptista, G.B.

1978-01-01

The environmental impact of a nuclear industry at an early stage of development is examined vis-a-vis the experience accumulated in studies on the environmental impact of the nuclear fuel cycle in a developed country. Differences in the optics of the nuclear industry in a developed country and that of segments of the public opinion are briefly discussed. Some peculiar aspects of a nuclear industry being implanted in a developing nation, including adoption of new legislation and regulations, are presented, taking into account the unusual opportunity to attack potential problems in advance. The unique example of the pre-operational survey of a region surrounding a uranium mine in a developing nation is mentioned as an example of cooperation between the nuclear industry and the scientific community to minimize the environmental impact of uranium mining operations. The potential environmental impact of other stages of the nuclear fuel cycle is also examined. Further cooperation between the nuclear industry and the scientific community of Latin American countries is suggested to minimize the environmental impact of the nuclear fuel cycle in nations starting nuclear programs. (author)

Design considerations for single-stage and two-stage pneumatic pellet injectors

International Nuclear Information System (INIS)

Gouge, M.J.; Combs, S.K.; Fisher, P.W.; Milora, S.L.

1988-09-01

Performance of single-stage pneumatic pellet injectors is compared with several models for one-dimensional, compressible fluid flow. Agreement is quite good for models that reflect actual breech chamber geometry and incorporate nonideal effects such as gas friction. Several methods of improving the performance of single-stage pneumatic pellet injectors in the near term are outlined. The design and performance of two-stage pneumatic pellet injectors are discussed, and initial data from the two-stage pneumatic pellet injector test facility at Oak Ridge National Laboratory are presented. Finally, a concept for a repeating two-stage pneumatic pellet injector is described. 27 refs., 8 figs., 3 tabs

One-stage and two-stage penile buccal mucosa urethroplasty

African Journals Online (AJOL)

G. Barbagli

2015-12-02

Dec 2, 2015 ... there also seems to be a trend of decreasing urethritis and an increase of instrumentation and catheter related strictures in these countries as well [4–6]. The repair of penile urethral strictures may require one- or two- stage urethroplasty [7–10]. Certainly, sexual function can be placed at risk by any surgery ...

The moral legitimacy of entrepreneurs: An analysis of early-stage entrepreneurship across 26 countries.

OpenAIRE

Kibler, Ewald; Kautonen, Teemu

2014-01-01

This article will develop our socio-cultural understanding of entrepreneurship by examining the influence of the moral legitimacy of entrepreneurs in society on an individual’s engagement in early-stage entrepreneurship. A multilevel analysis conducted across 26 countries shows that the higher the perceived degree of moral legitimacy, the more likely an individual is to think about starting a business compared to not thinking about it; to start preparing a business as against just considering...

Early stage precipitation in aluminum alloys : An ab initio study

NARCIS (Netherlands)

Zhang, X.

2017-01-01

Multiscale computational materials science has reached a stage where many complicated phenomena or properties that are of great importance to manufacturing can be predicted or explained. The word “ab initio study” becomes commonplace as the development of density functional theory has enabled the

A novel method for the determination of sildenafil (Viagra(R)) and its metabolite (UK-103,320) in postmortem specimens using LC/MS/MS and LC/MS/MS/MS : final report.

Science.gov (United States)

2000-05-01

During the investigation of aviation accidents, postmortem samples from victims are submitted to the FAAs Civil Aeromedical Institute for drug analysis. Because new drugs are continually being released to the market, it is our laboratorys respo...

A Statistical Analysis of the Relationship of Distance and Mode of Transportation on Length of Stay at Brooke Army Medical Center

National Research Council Canada - National Science Library

Hagen, John

1997-01-01

.... Transportation Command's (TRANSCOM) aeromedical evacuation system, to determine their influence on length of hospital stay at Brooke Army Medical Center in FY 1996 in order to better understand the irnpact these patients have on utilization management...

Stage-discharge relationship in tidal channels

Science.gov (United States)

Kearney, W. S.; Mariotti, G.; Deegan, L.; Fagherazzi, S.

2016-12-01

Long-term records of the flow of water through tidal channels are essential to constrain the budgets of sediments and biogeochemical compounds in salt marshes. Statistical models which relate discharge to water level allow the estimation of such records from more easily obtained records of water stage in the channel. While there is clearly structure in the stage-discharge relationship, nonlinearity and nonstationarity of the relationship complicates the construction of statistical stage-discharge models with adequate performance for discharge estimation and uncertainty quantification. Here we compare four different types of stage-discharge models, each of which is designed to capture different characteristics of the stage-discharge relationship. We estimate and validate each of these models on a two-month long time series of stage and discharge obtained with an Acoustic Doppler Current Profiler in a salt marsh channel. We find that the best performance is obtained by models which account for the nonlinear and time-varying nature of the stage-discharge relationship. Good performance can also be obtained from a simplified version of these models which approximates the fully nonlinear and time-varying models with a piecewise linear formulation.

Evaluation of the Military Functional Assessment Program: Inter rater Reliability of Task Scores

Science.gov (United States)

2017-09-19

return-to-duty. Performance on the tasks is rated by a non-commissioned officer (NCO), occupational therapist, physical therapist, and mental health ...and additional ratings are provided on a subset of the tasks by an occupational therapist (OT), physical therapist (PT), and mental health (MH...3National Intrepid Center of Excellence United States Army Aeromedical Research Laboratory Aircrew Health and Performance Division September 2017

Bladder cancer staging in CT urography: effect of stage labels on statistical modeling of a decision support system

Science.gov (United States)

Gandikota, Dhanuj; Hadjiiski, Lubomir; Cha, Kenny H.; Chan, Heang-Ping; Caoili, Elaine M.; Cohan, Richard H.; Weizer, Alon; Alva, Ajjai; Paramagul, Chintana; Wei, Jun; Zhou, Chuan

2018-02-01

In bladder cancer, stage T2 is an important threshold in the decision of administering neoadjuvant chemotherapy. Our long-term goal is to develop a quantitative computerized decision support system (CDSS-S) to aid clinicians in accurate staging. In this study, we examined the effect of stage labels of the training samples on modeling such a system. We used a data set of 84 bladder cancers imaged with CT Urography (CTU). At clinical staging prior to treatment, 43 lesions were staged as below stage T2 and 41 were stage T2 or above. After cystectomy and pathological staging that is considered the gold standard, 10 of the lesions were upstaged to stage T2 or above. After correcting the stage labels, 33 lesions were below stage T2, and 51 were stage T2 or above. For the CDSS-S, the lesions were segmented using our AI-CALS method and radiomic features were extracted. We trained a linear discriminant analysis (LDA) classifier with leave-one-case-out cross validation to distinguish between bladder lesions of stage T2 or above and those below stage T2. The CDSS-S was trained and tested with the corrected post-cystectomy labels, and as a comparison, CDSS-S was also trained with understaged pre-treatment labels and tested on lesions with corrected labels. The test AUC for the CDSS-S trained with corrected labels was 0.89 +/- 0.04. For the CDSS-S trained with understaged pre-treatment labels and tested on the lesions with corrected labels, the test AUC was 0.86 +/- 0.04. The likelihood of stage T2 or above for 9 out of the 10 understaged lesions was correctly increased for the CDSS-S trained with corrected labels. The CDSS-S is sensitive to the accuracy of stage labeling. The CDSS-S trained with correct labels shows promise in prediction of the bladder cancer stage.

Is knowledge translation adequate? A quality assurance study of staging investigations in early stage breast cancer patients.

Science.gov (United States)

Han, Dolly; Hogeveen, Sophie; Sweet Goldstein, Miriam; George, Ralph; Brezden-Masley, Christine; Hoch, Jeffrey; Haq, Rashida; Simmons, Christine E

2012-02-01

After primary surgery, patients diagnosed with early stage breast cancer undergo radiological investigations based on pathologic stage of disease to rule out distant metastases. Published guidelines can aid clinicians in determining which tests are appropriate based on stage of disease. We wished to assess the consistency of radiological staging in an academic community oncology setting with standard guidelines and to determine the overall impact of non-adherence to these guidelines. A retrospective cohort study was conducted for new breast cancer patients seen at a single institution between January 2009 and April 2010. Patients were included if initial diagnosis and primary surgery was at this institution. Pathologic stage and radiological tests completed were recorded. A literature review was performed and the results were compared with those from this study to determine overall adherence rates. Subsequently, a cost analysis was performed to determine the financial impact at this centre. 231 patients met eligibility criteria for inclusion in this study. A large proportion of patients were over-staged with 129 patients (55%) undergoing unnecessary investigations according to guidelines. Specifically, 59% of stage I patients and 58% of stage II patients were over-investigated. Distant metastases at the time of diagnosis were found in three patients, all of whom had stage III disease (1.3%). The literature reviewed revealed similar non-adherence rates in other centres. The estimated cost of such non-adherence is in the range of $78 (CDN) per new early stage breast cancer patient seen at this centre. This oncology centre has a low adherence to practice guidelines for staging investigations in breast cancer patients, with 55% of patients undergoing unnecessary tests. Very few patients had metastases at diagnosis, and all had pathological stage III disease. Efforts may need to focus on improving knowledge translation across clinical oncology settings to increase

Article mounting and position adjustment stage

Science.gov (United States)

Cutburth, Ronald W.; Silva, Leonard L.

1988-01-01

An improved adjustment and mounting stage of the type used for the detection of laser beams is disclosed. A ring sensor holder has locating pins on a first side thereof which are positioned within a linear keyway in a surrounding housing for permitting reciprocal movement of the ring along the keyway. A rotatable ring gear is positioned within the housing on the other side of the ring from the linear keyway and includes an oval keyway which drives the ring along the linear keyway upon rotation of the gear. Motor-driven single-stage and dual (x, y) stage adjustment systems are disclosed which are of compact construction and include a large laser transmission hole.

A low-voltage Op Amp with rail-to-rail constant-gm input stage and a class AB rail-to-rail output stage

NARCIS (Netherlands)

Botma, J.H.; Wassenaar, R.F.; Wiegerink, Remco J.

1993-01-01

In this paper a low-voltage two-stage Op Amp is presented. The Op Amp features rail-to-rail operation and has an @put stage with a constant transconductance (%) over the entire common-mode input range. The input stage consists of an n- and a PMOS differential pair connected in parallel. The constant

Turbine stage model

International Nuclear Information System (INIS)

Kazantsev, A.A.

2009-01-01

A model of turbine stage for calculations of NPP turbine department dynamics in real time was developed. The simulation results were compared with manufacturer calculations for NPP low-speed and fast turbines. The comparison results have shown that the model is valid for real time simulation of all modes of turbines operation. The model allows calculating turbine stage parameters with 1% accuracy. It was shown that the developed turbine stage model meets the accuracy requirements if the data of turbine blades setting angles for all turbine stages are available [ru

A mid-term follow-up of Koutsogiannis’ osteotomy in adult-acquired flatfoot stage II and “early stage III”

Directory of Open Access Journals (Sweden)

Arvinius Camilla

2017-01-01

Full Text Available Introduction: Koutsogiannis’ osteotomy has been widely described to treat adult-acquired flatfoot. However, few articles describe its midterm follow-up. Our aim was to study clinical and radiological outcomes at least one year after surgery and to analyze whether a combined procedure on the medial soft tissue affected these outcomes. Methods: We performed a retrospective study of 30 feet of patients who underwent a Koutsogiannis’ osteotomy due to adult-acquired flatfoot stage II and “early stage III”: a stage III acquired flatfoot without any important structural deformities. The parameters studied were additional medial soft tissue procedures, clinical outcome through the American Orthopaedic Foot and Ankle Society (AOFAS ankle and midfoot score as well as complications and radiological measurements. Results: Sixteen cases were “early stage III” and 14 stage II. Thirteen patients underwent an associated posterior tibial tendon (PTT revision: in three cases an end-to-end suture was possible, seven cases needed a FDL transposition, and three underwent synovectomy. Statistically significant improvement was found in the AOFAS score although no significant changes were seen radiologically. No additional benefit was found with the revision of the posterior tibial tendon. As to clinical and radiological results, no differences were found between stage II and “early stage III”. Five cases presented a mild dysesthesia but only one patient needed neurolysis. Conclusions: We consider the Koutsogiannis’ osteotomy to be a safe and effective procedure to reduce pain in patients with stage II and “early stage III” adult-acquired flatfoot.

On the creation of scalar particles in an early stage of the Friedmann closed-universe

International Nuclear Information System (INIS)

Ishihara, Hideki; Nariai, Hidekazu.

1982-03-01

Under impetus of the two experimental studies on neutrinos by Reines-group and Lyubimov's, it has been shown by Zel'dovich et al. that the cosmological universe is closed, provided that the neutrino masses m sub(#betta#sub(i)) (i = e, μ, tau) satisfy the inequality μ/i m sub(#betta#sub(i))c 2 >= 20 ev. In a previous paper, the senior author dealt with the creation of scalar particles in an expanding universe with non-flat 3-space, but the case of a closed universe was practically ignored owing to the situation that the positive frequency part (in the sense of the author) of a quantized scalar field is not well-defined in that universe. In view of these circumstances, the creation of scalar particles in an early stage of the Friedmann closed-universe is searched for, on the supposition that the Fulling condition is preferable to define the positive frequency part in question near the early stage (as well as the later one). (author)

Two-stage implant placement technique for the management of irradiated jaws: An animal study.

Science.gov (United States)

Aboushelib, Moustafa N; Arnaout, Mohamed A; Elsafi, Mohamed H; Kassem, Youssef M

2017-10-01

Radiotherapy results in diminished bone remodeling capacity and an elevated risk of osteoradionecrosis, which can negatively influence the survival rate of dental implants. Patients receiving radiotherapy are advised not to receive dental implants during or soon after completing their radiotherapy. The purpose of this animal study was to investigate a 2-stage implant placement technique designed to diminish applied trauma on irradiated bone. Two groups of white New Zealand rabbits received radiotherapy in ascending doses (2, 4, 8 Gy), while a nonirradiated group served as control. Three weeks after completion of the last radiotherapy session, one of the irradiated groups and the control group received titanium dental implants bilaterally in the femur head. For the second irradiated group, an osteotomy was performed, and the surgical wound was left to heal for 2 weeks before implant placement. All animals were sacrificed 4 weeks after implant placement, and histomorphometric analysis was used to study bone-implant contact (n=14, α=.05). Statistical analysis revealed significantly higher (F=159, P<.001) bone-implant contact in the 2-stage (40.2 ±1.9) implant placement technique than in the immediately placed implants (21.2 ±2.3) in irradiated bone. Both of the groups had a significantly lower bone-to-implant contact ratio than the non-irradiated control (64.2 ±3.8). Within the limitations of this animal study, the 2-stage implant placement technique could be used to reduce trauma in irradiated bone and to improve wound healing around dental implants. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Ash related behaviour in staged and non-staged combustion of biomass fuels and fuel mixtures

International Nuclear Information System (INIS)

Becidan, Michaël; Todorovic, Dusan; Skreiberg, Øyvind; Khalil, Roger A.; Backman, Rainer; Goile, Franziska; Skreiberg, Alexandra; Jovovic, Aleksandar; Sørum, Lars

2012-01-01

The fate of selected elements (with focus on the important players in corrosion i.e. Na, K, Pb, Zn, Cl and S) are investigated for three biomasses (wood, demolition wood and coffee waste) and six mixtures of these as pellets both with and without air staging in a laboratory reactor. In order to get a complete overview of the combustion products, both online and offline analytical methods are used. Information is collected about: flue gas composition, particle (fly ash) size distribution and composition, bottom ash composition and melting properties. The main findings are: (1) complex interactions are taking place between the mixed fuels during combustion; (2) the mode of occurrence of an element as well as the overall structure of the fuel are important for speciation; (3) the pelletisation process, by bringing chemical elements into intimate contact, may affect partitioning and speciation; (4) staging and mixing might simultaneously have positive and negative effects on operation; (5) staging affects the governing mechanisms of fly ash (aerosols) formation. -- Highlights: ► Complex interactions are taking place between the mixed fuels during combustion. ► The mode of occurrence of an element as well as the overall structure of the fuel are important for speciation. ► The pelletisation process, by bringing chemical elements into intimate contact, may affect partitioning and speciation. ► Staging and mixing might simultaneously have positive and negative effects on operation. ► Staging affects the governing mechanisms of fly ash (aerosols) formation.

Summary Stage 2018 - SEER

Science.gov (United States)

Access this manual of codes and coding instructions for the summary stage field for cases diagnosed January 1, 2018 and forward. 2018 version applies to every site and/or histology combination, including lymphomas and leukemias. Historically, also called General Staging, California Staging, and SEER Staging.

An inhibitor of polyamine synthesis arrests cells at an earlier stage of G1 than does calcium deprivation.

OpenAIRE

Cheetham, B F

1983-01-01

Methylglyoxal bis(guanylhydrazone) completely inhibits the induction of thymidine kinase after serum stimulation of quiescent fibroblasts only if added within 3 h after serum, whereas calcium deprivation blocks this induction up to 12 h after serum stimulation. Experiments in which one of these blocks was imposed as the other was released confirmed that cells blocked by methylglyoxal bis(guanylhydrazone) are arrested at an earlier stage in G1 than cells blocked by calcium deprivation.

Multi-Stage System for Automatic Target Recognition

Science.gov (United States)

Chao, Tien-Hsin; Lu, Thomas T.; Ye, David; Edens, Weston; Johnson, Oliver

2010-01-01

A multi-stage automated target recognition (ATR) system has been designed to perform computer vision tasks with adequate proficiency in mimicking human vision. The system is able to detect, identify, and track targets of interest. Potential regions of interest (ROIs) are first identified by the detection stage using an Optimum Trade-off Maximum Average Correlation Height (OT-MACH) filter combined with a wavelet transform. False positives are then eliminated by the verification stage using feature extraction methods in conjunction with neural networks. Feature extraction transforms the ROIs using filtering and binning algorithms to create feature vectors. A feedforward back-propagation neural network (NN) is then trained to classify each feature vector and to remove false positives. The system parameter optimizations process has been developed to adapt to various targets and datasets. The objective was to design an efficient computer vision system that can learn to detect multiple targets in large images with unknown backgrounds. Because the target size is small relative to the image size in this problem, there are many regions of the image that could potentially contain the target. A cursory analysis of every region can be computationally efficient, but may yield too many false positives. On the other hand, a detailed analysis of every region can yield better results, but may be computationally inefficient. The multi-stage ATR system was designed to achieve an optimal balance between accuracy and computational efficiency by incorporating both models. The detection stage first identifies potential ROIs where the target may be present by performing a fast Fourier domain OT-MACH filter-based correlation. Because threshold for this stage is chosen with the goal of detecting all true positives, a number of false positives are also detected as ROIs. The verification stage then transforms the regions of interest into feature space, and eliminates false positives using an

Between Stage and Screen

NARCIS (Netherlands)

Tornqvist, Egil

1996-01-01

Ingmar Bergman is worldwide known as a film and stage director. Yet no-one has attempted to compare his stage and screen activities. In Between stage and screen Egil Tornqvist examines formal and thematical correspondences and differences between a number of Bergman's stage, screen, and radio

Modeling bacterial attachment to surfaces as an early stage of biofilm development.

Science.gov (United States)

El Moustaid, Fadoua; Eladdadi, Amina; Uys, Lafras

2013-06-01

Biofilms are present in all natural, medical and industrial surroundings where bacteria live. Biofilm formation is a key factor in the growth and transport of both beneficial and harmful bacteria. While much is known about the later stages of biofilm formation, less is known about its initiation which is an important first step in the biofilm formation. In this paper, we develop a non-linear system of partial differential equations of Keller-Segel type model in one-dimensional space, which couples the dynamics of bacterial movement to that of the sensing molecules. In this case, bacteria perform a biased random walk towards the sensing molecules. We derive the boundary conditions of the adhesion of bacteria to a surface using zero-Dirichlet boundary conditions, while the equation describing sensing molecules at the interface needed particular conditions to be set. The numerical results show the profile of bacteria within the space and the time evolution of the density within the free-space and on the surface. Testing different parameter values indicate that significant amount of sensing molecules present on the surface leads to a faster bacterial movement toward the surface which is the first step of biofilm initiation. Our work gives rise to results that agree with the biological description of the early stages of biofilm formation.

Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy

International Nuclear Information System (INIS)

Vinogradskiy, Yevgeniy; Schubert, Leah; Diot, Quentin; Waxweiller, Timothy; Koo, Phillip; Castillo, Richard; Castillo, Edward; Guerrero, Thomas; Rusthoven, Chad; Gaspar, Laurie; Kavanagh, Brian; Miften, Moyed

2016-01-01

Purpose: The development of clinical trials is underway to use 4-dimensional computed tomography (4DCT) ventilation imaging to preferentially spare functional lung in patients undergoing radiation therapy. The purpose of this work was to generate data to aide with clinical trial design by retrospectively characterizing dosimetric and functional profiles for patients with different stages of lung cancer. Methods and Materials: A total of 118 lung cancer patients (36% stage I and 64% stage III) from 2 institutions were used for the study. A 4DCT-ventilation map was calculated using the patient's 4DCT imaging, deformable image registration, and a density-change–based algorithm. To assess each patient's spatial ventilation profile both quantitative and qualitative metrics were developed, including an observer-based defect observation and metrics based on the ventilation in each lung third. For each patient we used the clinical doses to calculate functionally weighted mean lung doses and metrics that assessed the interplay between the spatial location of the dose and high-functioning lung. Results: Both qualitative and quantitative metrics revealed a significant difference in functional profiles between the 2 stage groups (P<.01). We determined that 65% of stage III and 28% of stage I patients had ventilation defects. Average functionally weighted mean lung dose was 19.6 Gy and 5.4 Gy for stage III and I patients, respectively, with both groups containing patients with large spatial overlap between dose and high-function regions. Conclusion: Our 118-patient retrospective study found that 65% of stage III patients have regionally variant ventilation profiles that are suitable for functional avoidance. Our results suggest that regardless of disease stage, it is possible to have unique spatial interplay between dose and high-functional lung, highlighting the importance of evaluating the function of each patient and developing a personalized functional avoidance

Regional Lung Function Profiles of Stage I and III Lung Cancer Patients: An Evaluation for Functional Avoidance Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Schubert, Leah; Diot, Quentin; Waxweiller, Timothy [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Koo, Phillip [Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado (United States); Castillo, Richard [Department of Radiation Oncology, University of Texas Medical Branch, Galveston, Texas (United States); Castillo, Edward; Guerrero, Thomas [Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan (United States); Rusthoven, Chad; Gaspar, Laurie; Kavanagh, Brian; Miften, Moyed [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

2016-07-15

Purpose: The development of clinical trials is underway to use 4-dimensional computed tomography (4DCT) ventilation imaging to preferentially spare functional lung in patients undergoing radiation therapy. The purpose of this work was to generate data to aide with clinical trial design by retrospectively characterizing dosimetric and functional profiles for patients with different stages of lung cancer. Methods and Materials: A total of 118 lung cancer patients (36% stage I and 64% stage III) from 2 institutions were used for the study. A 4DCT-ventilation map was calculated using the patient's 4DCT imaging, deformable image registration, and a density-change–based algorithm. To assess each patient's spatial ventilation profile both quantitative and qualitative metrics were developed, including an observer-based defect observation and metrics based on the ventilation in each lung third. For each patient we used the clinical doses to calculate functionally weighted mean lung doses and metrics that assessed the interplay between the spatial location of the dose and high-functioning lung. Results: Both qualitative and quantitative metrics revealed a significant difference in functional profiles between the 2 stage groups (P<.01). We determined that 65% of stage III and 28% of stage I patients had ventilation defects. Average functionally weighted mean lung dose was 19.6 Gy and 5.4 Gy for stage III and I patients, respectively, with both groups containing patients with large spatial overlap between dose and high-function regions. Conclusion: Our 118-patient retrospective study found that 65% of stage III patients have regionally variant ventilation profiles that are suitable for functional avoidance. Our results suggest that regardless of disease stage, it is possible to have unique spatial interplay between dose and high-functional lung, highlighting the importance of evaluating the function of each patient and developing a personalized functional

A generic model for evaluation of the Federal Aviation Administration air traffic control specialist training programs.

Science.gov (United States)

1982-03-01

The Systems Analysis Research Unit at the Civil Aeromedical Institute (CAMI) has developed a generic model for Federal Aviation Administration (FAA) Academy training program evaluation. The model will serve as a basis for integrating the total data b...

Single-stage Acetabular Revision During Two-stage THA Revision for Infection is Effective in Selected Patients.

Science.gov (United States)

Fink, Bernd; Schlumberger, Michael; Oremek, Damian

2017-08-01

The treatment of periprosthetic infections of hip arthroplasties typically involves use of either a single- or two-stage (with implantation of a temporary spacer) revision surgery. In patients with severe acetabular bone deficiencies, either already present or after component removal, spacers cannot be safely implanted. In such hips where it is impossible to use spacers and yet a two-stage revision of the prosthetic stem is recommended, we have combined a two-stage revision of the stem with a single revision of the cup. To our knowledge, this approach has not been reported before. (1) What proportion of patients treated with single-stage acetabular reconstruction as part of a two-stage revision for an infected THA remain free from infection at 2 or more years? (2) What are the Harris hip scores after the first stage and at 2 years or more after the definitive reimplantation? Between June 2009 and June 2014, we treated all patients undergoing surgical treatment for an infected THA using a single-stage acetabular revision as part of a two-stage THA exchange if the acetabular defect classification was Paprosky Types 2B, 2C, 3A, 3B, or pelvic discontinuity and a two-stage procedure was preferred for the femur. The procedure included removal of all components, joint débridement, definitive acetabular reconstruction (with a cage to bridge the defect, and a cemented socket), and a temporary cemented femoral component at the first stage; the second stage consisted of repeat joint and femoral débridement and exchange of the femoral component to a cementless device. During the period noted, 35 patients met those definitions and were treated with this approach. No patients were lost to followup before 2 years; mean followup was 42 months (range, 24-84 months). The clinical evaluation was performed with the Harris hip scores and resolution of infection was assessed by the absence of clinical signs of infection and a C-reactive protein level less than 10 mg/L. All

Staged licensing: An essential element of the NRC's revised regulations

International Nuclear Information System (INIS)

Echols, F.S.

1997-01-01

Over the past several years, Congress has directed the Department of Energy (DOE), the Nuclear Regulatory Commission (NRC), and the Environmental Protection Agency (EPA) to abandon their efforts to assess an array of potential candidate geologic repository sites for the permanent disposal of spent nuclear reactor fuel and high level radioactive waste, to develop generally applicable requirements for licensing geologic repositories, and to develop generally applicable radiation protection standards for geologic repositories, and instead to focus their efforts to determine whether a single site located at Yucca Mountain, Nevada can be developed as a geologic repository which providing reasonable assurance that public health and safety and the environment will be adequately protected. If the Yucca Mountain site is found to be suitable for development as a geologic repository, then at each stage of development DOE will have to provide the NRC with progressively more detailed information regarding repository design and long-term performance. NRC regulations reflect the fact that it will not be until the repository has been operated for a number of years that the NRC will be able to make a final determination as to long-term repository performance. Nevertheless, the NRC will be able to allow DOE to construct and operate a repository, provided that the NRC believes that the documented results of existing studies, together with the anticipated results from continuing and future studies, will enable the NRC to make a final determination that it has reasonable assurance that the repository system's long-term performance will not cause undue risk to the public. Thus, in its efforts to revise its current regulations to assure that the technical criteria are specifically applicable to the Yucca Mountain site, the NRC should also make sure that it preserves and clarifies the concept of staged repository development

Structure, texture, and mechanical properties of an MA2-1hp magnesium alloy after two-stage equal-channel angular pressing and intermediate annealing

Science.gov (United States)

Serebryany, V. N.; Perezhogin, V. Yu.; Raab, G. I.; Kopylov, V. I.; Tabachkova, N. Yu.; Sirotinkin, V. P.; Dobatkin, S. V.

2015-01-01

The effect of two-stage equal-channel angular pressing (ECAP) on the microstructure, the texture, and the mechanical properties of an MA2-1hp magnesium alloy is analyzed. ECAP leads to the formation of a submicrocrystalline structure with an average grain size of 640 nm, which includes Mg17Al12 phase particles with an average grain size of 240 nm and a volume fracture of 5.5%. A scattered tilted basal texture forms after ECAP, and its experimental pole figures are used for calculating orientation distribution functions and determining the volume fractions of the main orientations and the Schmid factors for different deformation systems. An increased activation of basal slip is found after both the first and the second stages of ECAP. As a result of two-stage ECAP, the strength properties of the alloy that correspond to the minimum acceptable values achieved by direct compression are obtained. Ductility is 44 and 18% after the first stage of ECAP plus subsequent annealing and after the second stage, respectively, which is almost four and two times higher than the initial value. The resulting strength mechanical properties of the alloy after the first and the second ECAP stages are analyzed using the Hall-Petch relation.

An empirical test of stage models of e-government development: evidence from Dutch municipalities

NARCIS (Netherlands)

Rooks, G.; Matzat, U.; Sadowski, B.M.

2017-01-01

In this article we empirically test stage models of e-government development. We use Lee's classification to make a distinction between four stages of e-government: informational, requests, personal, and e-democracy. We draw on a comprehensive data set on the adoption and development of e-government

Multi-stage internal gear/turbine fuel pump

Energy Technology Data Exchange (ETDEWEB)

Maier, Eugen; Raney, Michael Raymond

2004-07-06

A multi-stage internal gear/turbine fuel pump for a vehicle includes a housing having an inlet and an outlet and a motor disposed in the housing. The multi-stage internal gear/turbine fuel pump also includes a shaft extending axially and disposed in the housing. The multi-stage internal gear/turbine fuel pump further includes a plurality of pumping modules disposed axially along the shaft. One of the pumping modules is a turbine pumping module and another of the pumping modules is a gerotor pumping module for rotation by the motor to pump fuel from the inlet to the outlet.

Preoperative staging of rectal cancer; Praeoperatives Staging des Rektumkarzinoms

Energy Technology Data Exchange (ETDEWEB)

Schaefer, A.O.; Baumann, T.; Pache, G.; Langer, M. [Abt. Roentgendiagnostik, Radiologische Universitaetsklinik Freiburg, Freiburg im Breisgau (Germany); Wiech, T. [Inst. fuer Pathologie, Universitaetsklinik Freiburg, Freiburg (Germany)

2007-07-15

Accurate preoperative staging of rectal cancer is crucial for therapeutic decision making, as local tumor extent, nodal status, and patterns of metastatic spread are directly associated with different treatment strategies. Recently, treatment approaches have been widely standardized according to large studies and consensus guidelines. Introduced by Heald, total mesorectal excision (TME) is widely accepted as the surgical procedure of choice to remove the rectum together with its enveloping tissues and the mesorectal fascia. Neoadjuvant radiochemotherapy also plays a key role in the treatment of locally advanced stages, while the use of new drugs will lead to a further improvement in oncological outcome. Visualization of the circumferential resection margin is the hallmark of any preoperative imaging and a prerequisite for high-quality TME surgery. The aim of this article is to present an overview on current cross-sectional imaging with emphasis on magnetic resonance imaging. Future perspectives in rectal cancer imaging are addressed. (orig.)

Situational variation in moral judgment: In a stage or on a stage?

Science.gov (United States)

Carpendale, J I; Krebs, D L

1992-04-01

Two issues were examined in this study-the consistency of moral judgment across different types of dilemma and different social contexts, and the relationship between the structure (stage) of moral judgment and the content of moral decisions. Forty subjects were given two hypothetical dilemmas about business decisions and two standard Kohlberg dilemmas. Half the subjects directed their responses to a business audience, half to a philosophical audience. Responses to the moral dilemmas were scored in accordance with the Colby and Kohlberg (1987) scoring manual. Stage of moral reasoning was found to be significantly higher on the Kohlberg dilemmas than on the business dilemmas. A significant interaction between type of dilemma and audience was attributed to the tendency of subjects directing their responses to a business audience to interpret one of the business dilemmas in terms of the moral order of business, but for subjects directing their responses to a philosophy audience to treat it as a philosophical dilemma. The other business dilemma evoked uniformly low-level moral judgments. The amount of selfishness intrinsic in subjects' moral choices on the business dilemmas was significantly negatively correlated with moral maturity on the business dilemmas, but not with their moral maturity on Kohlberg's test. These results are interpreted as more consistent with models of moral development such as those advanced by C. G. Levine ([1979] "Stage Acquisition and Stage Use: An Appraisal of Stage Displacement Explanations of Variation in Moral Reasoning, " Human Development, Vol. 22, pp. 145-164), J. Rest ([1983] "Morality," in: P. H. Mussen [ed.], J. H. Flavell and E. Markman [Vol. eds.], Handbook of Child Psychology [Vol. 3, 4th ed.], John Wiley & Sons, New York), and R. Harré ([1984]) Personal Being: A Theory for Individual Psychology, Harvard University Press, Cambridge, Massachusetts), which posit a relatively wide range of within-person stage use and emphasize the

An inhibitor of polyamine synthesis arrests cells at an earlier stage of G1 than does calcium deprivation.

Science.gov (United States)

Cheetham, B F

1983-01-01

Methylglyoxal bis(guanylhydrazone) completely inhibits the induction of thymidine kinase after serum stimulation of quiescent fibroblasts only if added within 3 h after serum, whereas calcium deprivation blocks this induction up to 12 h after serum stimulation. Experiments in which one of these blocks was imposed as the other was released confirmed that cells blocked by methylglyoxal bis(guanylhydrazone) are arrested at an earlier stage in G1 than cells blocked by calcium deprivation. PMID:6843551

Grids heat loading of an ion source in two-stage acceleration system

International Nuclear Information System (INIS)

Okumura, Yoshikazu; Ohara, Yoshihiro; Ohga, Tokumichi

1978-05-01

Heat loading of the extraction grids, which is one of the critical problems limiting the beam pulse duration at high power level, has been investigated experimentally, with an ion source in a two-stage acceleration system of four multi-aperture grids. The loading of each grid depends largely on extraction current and grid gap pressures; it decreases with improvement of the beam optics and with decrease of the pressures. In optimum operating modes, its level is typically less than -- 2% of the total beam power or -- 200 W/cm 2 at beam energies of 50 - 70 kV. (auth.)

Interconnected levels of multi-stage marketing: A triadic approach

OpenAIRE

Vedel, Mette; Geersbro, Jens; Ritter, Thomas

2012-01-01

Multi-stage marketing gains increasing attention as knowledge of and influence on the customer's customer become more critical for the firm's success. Despite this increasing managerial relevance, systematic approaches for analyzing multi-stage marketing are still missing. This paper conceptualizes different levels of multi-stage marketing and illustrates these stages with a case study. In addition, a triadic perspective is introduced as an analytical tool for multi-stage marketing research. ...

The first preliminary experiments on an 84 GHz gyrotron with a single-stage depressed collector

International Nuclear Information System (INIS)

Shimozuma, T.; Sato, M.; Takita, Y.

1997-10-01

We fabricated and tested an 84GHz gyrotron with a single-stage depressed collector. The gyrotron has a high-voltage insulating section made of a low loss silicon nitride composite. In this preliminary experiment in the depressed collector configuration, we obtained 591kW, 41% operation with a depression voltage of 22.5kV. Access to the higher efficiency region was inhibited by an increase in anode current. (author)

Proceedings of the Military Operational Medicine Research Program Return to Duty (RTD) Toolkit Expert Panel Workshop, 16-17 February 2017

Science.gov (United States)

2017-07-10

Laboratory 2Oak Ridge Institute for Science and Education United States Army Aeromedical Research Laboratory Aircrew Health and Performance Division...excluded from the RTD Toolkit Manual, 2) to identify any additional tasks and clinical assessments for inclusion in the RTD Toolkit Manual, and 3) to agree...for Science and Education through an interagency agreement between the U.S. Department of Energy and the U.S. Army Medical Research and Materiel

PET/CT staging of T1-stage non-small cell lung cancer

International Nuclear Information System (INIS)

Salman, K. A.; Steinmann, C. H.; Von Schulthess, G. K.; Steinert, H. C.; Sukumar, V. P.

2009-01-01

Full text:Purpose: To evaluate the value of PET/CT in detecting occult metastases in patients with T 1 -stage non-small cell lung cancer (NSCLC). Method: Patients with proven NSCLC and T 1 -stage ( c m) were retrospectively analyzed. In all patients a whole-body 18 F-FDG PET/CT scan for initial staging was performed. The PET/CT findings were compared with all available clinical information, intra-operative findings and the histopathological results. Results: 95 patients (39 men, 56 women; age range, 19-85 years) were analyzed in our study. PET/CT in 68-95 patients correctly excluded mediastinal and distant metastases. In 17/95 patients (18%) mediastinal lymph-node metastases were proven (N 2 n=15; N 3 n=2). PET/CT correctly detected in 10/17 patients (58.8%) mediastinal nodal disease. The smallest mediastinal lymph-node metastasis detected by PET/CT had a size of 0.7 c m. In 7 patients PET/CT missed N 2 -stage. In three of these patients the SUVmax of the primary was c m. Only in one missed N 2 -stage metastasis was sized > 1.0 c m. The tumor histology (adenocarcinoma, squamous cell carcinoma) and location of the primary (central, periphery) did not influence the missed N 2 -stage by PET/CT. PET/CT diagnosed correctly N 3 -stage in 2 patients. 10/95 patients (10.5%) had distant metastases. PET/CT detected unknown M 1 -stage in 4/10 patients. In one patient a metastasis of the parietal pleura was missed by PET/CT. Conclusion: In our study, 28% patients with T 1 -stage NSCLC showed mediastinal or distant metastases. PET/CT was efficient in the detection of occult metastases. However, the sensitivity of PET/CT in mediastinal staging was only 64%.

"Stage 40" Handbook.

Science.gov (United States)

Mill River Union High School, North Clarendon, VT.

The policies, purposes, and guidelines of "Stage 40," an educational repertory company for students, are presented in this paper, which also explains how the company functions. The paper discusses the company's history, the relationship between the company and academics, and the responsibilities of a company member. Letters by the board…

Locally advanced breast cancer (stage III and stage IV)

International Nuclear Information System (INIS)

Baracat, F.F.; Grabert, H.; Lima, G.R. de; Pontes, M.; Ferraro, O.; Santana, A.; Brook, E.S.

1987-01-01

The results concerning to the treatment of 193 patients with locally advanced breast cancer-stage III and stage IV are analysed. All the patients were treated with radical radiotherapy plus total mastectomy about 6 weeks later; 53 pacients received also chemotherapy (CMF - 12 courses) and 52 were oophorectomized. (M.A.C) [pt

AN INTEGRATED MODEL FOR MANAGING INNOVATION IN THE EARLY STAGES OF NEW PRODUCT DEVELOPMENT IN SMES(RIKON Group)

OpenAIRE

Flinders, Clare; Lynch, Patrick; Holden, Mary T.

2009-01-01

This paper centralises the management of innovation in the early stages of the new product development (NPD) process. The purpose of this paper is to describe the critical episodes that enabled an SME to successfully manage the development of new product concepts from inception and, in so doing, presents implementable guidelines that can be used by SMEs to manage the delivery of creative and attractive new product concepts in the early stages of NPD. Action research was used to conduct a thre...

Two-Stage Variable Sample-Rate Conversion System

Science.gov (United States)

Tkacenko, Andre

2009-01-01

A two-stage variable sample-rate conversion (SRC) system has been pro posed as part of a digital signal-processing system in a digital com munication radio receiver that utilizes a variety of data rates. The proposed system would be used as an interface between (1) an analog- todigital converter used in the front end of the receiver to sample an intermediatefrequency signal at a fixed input rate and (2) digita lly implemented tracking loops in subsequent stages that operate at v arious sample rates that are generally lower than the input sample r ate. This Two-Stage System would be capable of converting from an input sample rate to a desired lower output sample rate that could be var iable and not necessarily a rational fraction of the input rate.

A Novel Inflammation-Based Stage (I Stage in Patients with Resectable Esophageal Squamous Cell Carcinoma

Directory of Open Access Journals (Sweden)

Peng-Cheng Chen

2016-01-01

Full Text Available Background. Inflammation plays a key role in cancer. In the current study, we proposed a novel inflammation-based stage, named I stage, for patients with resectable esophageal squamous cell carcinoma (ESCC. Methods. Three hundred and twenty-three patients with resectable ESCC were enrolled in the current study. The I stage was calculated as follows: patients with high levels of C-reactive protein (CRP (>10 mg/L, neutrophil-to-lymphocyte ratio (NLR (>3.5, and platelet-count-to-lymphocyte ratio (PLR (>150 were defined as I3. Patients with two, one, or no abnormal value were defined as I2, I1, or I0, respectively. The prognostic factors were evaluated by univariate and multivariate analyses. Results. There were 112 patients for I0, 97 patients for I1, 66 patients for I2, and 48 patients for I3, respectively. The 5-year cancer-specific survival (CSS in patients with I0, I1, I2, and I3 was 50.0%, 30.9%, 18.2%, and 8.3%, respectively (I0 versus I1, P=0.002; I1 versus I2, P=0.012; I2 versus I3, P=0.020. Multivariate analyses revealed that I stage was an independent prognostic factor in patients with resectable ESCC (P<0.001. Conclusion. The inflammation-based stage (I stage is a novel and useful predictive factor for CSS in patients with resectable ESCC.

Success of Two-Stage Reimplantation in Patients Requiring an Interim Spacer Exchange.

Science.gov (United States)

George, Jaiben; Miller, Evan M; Curtis, Gannon L; Klika, Alison K; Barsoum, Wael K; Mont, Michael A; Higuera, Carlos A

2018-03-23

Some patients undergoing a 2-stage revision for a periprosthetic joint infection require a repeat spacer in the interim (removal of existing spacer with insertion of a new spacer or spacer exchange) due to persistent infection. The objectives of this study are to (1) determine the factors associated with patients who receive a repeat spacer and (2) compare the infection-free survival (overall and stratified by joint type) of reimplantation in patients who did or did not receive a repeat spacer. From 2001 to 2014, 347 hip or knee 2-stage revisions that finally underwent reimplantation and had a minimum 2-year follow-up were identified. An interim spacer exchange was performed in 59 (17%) patients (exchange cohort). Patient-related and organism-related factors were compared between the exchange and non-exchange cohorts. Kaplan-Meier survival curves were performed to assess the success (absence of signs of infection, reoperation for infection, periprosthetic joint infection-related mortality) of both cohorts. Patients in the exchange group had higher comorbidity score (P = .020), prolonged time to reimplantation (P exchange cohort, and 78% (knee 77%, hip 78%) in the non-exchange cohort (P = .020). Patients requiring an interim spacer exchange were found to have more comorbidities, prolonged treatment period, and were more likely to be infected with a resistant organism. About one-third of such patients became reinfected within 5 years compared to only one-fifth of the patients without an interim spacer exchange. Copyright © 2018 Elsevier Inc. All rights reserved.

A Dual-Stage Two-Phase Model of Selective Attention

Science.gov (United States)

Hubner, Ronald; Steinhauser, Marco; Lehle, Carola

2010-01-01

The dual-stage two-phase (DSTP) model is introduced as a formal and general model of selective attention that includes both an early and a late stage of stimulus selection. Whereas at the early stage information is selected by perceptual filters whose selectivity is relatively limited, at the late stage stimuli are selected more efficiently on a…

Updated baseline for a staged Compact Linear Collider

CERN Document Server

Boland, M J; Giansiracusa, P J; Lucas, T G; Rassool, R P; Balazs, C; Charles, T K; Afanaciev, K; Emeliantchik, I; Ignatenko, A; Makarenko, V; Shumeiko, N; Patapenka, A; Zhuk, I; Abusleme Hoffman, A C; Diaz Gutierrez, M A; Gonzalez, M Vogel; Chi, Y; He, X; Pei, G; Pei, S; Shu, G; Wang, X; Zhang, J; Zhao, F; Zhou, Z; Chen, H; Gao, Y; Huang, W; Kuang, Y P; Li, B; Li, Y; Shao, J; Shi, J; Tang, C; Wu, X; Ma, L; Han, Y; Fang, W; Gu, Q; Huang, D; Huang, X; Tan, J; Wang, Z; Zhao, Z; Laštovička, T; Uggerhoj, U; Wistisen, T N; Aabloo, A; Eimre, K; Kuppart, K; Vigonski, S; Zadin, V; Aicheler, M; Baibuz, E; Brücken, E; Djurabekova, F; Eerola, P; Garcia, F; Haeggström, E; Huitu, K; Jansson, V; Karimaki, V; Kassamakov, I; Kyritsakis, A; Lehti, S; Meriläinen, A; Montonen, R; Niinikoski, T; Nordlund, K; Österberg, K; Parekh, M; Törnqvist, N A; Väinölä, J; Veske, M; Farabolini, W; Mollard, A; Napoly, O; Peauger, F; Plouin, J; Bambade, P; Chaikovska, I; Chehab, R; Davier, M; Kaabi, W; Kou, E; LeDiberder, F; Pöschl, R; Zerwas, D; Aimard, B; Balik, G; Baud, J-P; Blaising, J-J; Brunetti, L; Chefdeville, M; Drancourt, C; Geoffroy, N; Jacquemier, J; Jeremie, A; Karyotakis, Y; Nappa, J M; Vilalte, S; Vouters, G; Bernard, A; Peric, I; Gabriel, M; Simon, F; Szalay, M; van der Kolk, N; Alexopoulos, T; Gazis, E N; Gazis, N; Ikarios, E; Kostopoulos, V; Kourkoulis, S; Gupta, P D; Shrivastava, P; Arfaei, H; Dayyani, M K; Ghasem, H; Hajari, S S; Shaker, H; Ashkenazy, Y; Abramowicz, H; Benhammou, Y; Borysov, O; Kananov, S; Levy, A; Levy, I; Rosenblat, O; D'Auria, G; Di Mitri, S; Abe, T; Aryshev, A; Higo, T; Makida, Y; Matsumoto, S; Shidara, T; Takatomi, T; Takubo, Y; Tauchi, T; Toge, N; Ueno, K; Urakawa, J; Yamamoto, A; Yamanaka, M; Raboanary, R; Hart, R; van der Graaf, H; Eigen, G; Zalieckas, J; Adli, E; Lillestøl, R; Malina, L; Pfingstner, J; Sjobak, K N; Ahmed, W; Asghar, M I; Hoorani, H; Bugiel, S; Dasgupta, R; Firlej, M; Fiutowski, T A; Idzik, M; Kopec, M; Kuczynska, M; Moron, J; Swientek, K P; Daniluk, W; Krupa, B; Kucharczyk, M; Lesiak, T; Moszczynski, A; Pawlik, B; Sopicki, P; Wojtoń, T; Zawiejski, L; Kalinowski, J; Krawczyk, M; Żarnecki, A F; Firu, E; Ghenescu, V; Neagu, A T; Preda, T; Zgura, I-S; Aloev, A; Azaryan, N; Budagov, J; Chizhov, M; Filippova, M; Glagolev, V; Gongadze, A; Grigoryan, S; Gudkov, D; Karjavine, V; Lyablin, M; Olyunin, A; Samochkine, A; Sapronov, A; Shirkov, G; Soldatov, V; Solodko, A; Solodko, E; Trubnikov, G; Tyapkin, I; Uzhinsky, V; Vorozhtov, A; Levichev, E; Mezentsev, N; Piminov, P; Shatilov, D; Vobly, P; Zolotarev, K; Bozovic-Jelisavcic, I; Kacarevic, G; Lukic, S; Milutinovic-Dumbelovic, G; Pandurovic, M; Iriso, U; Perez, F; Pont, M; Trenado, J; Aguilar-Benitez, M; Calero, J; Garcia-Tabares, L; Gavela, D; Gutierrez, J L; Lopez, D; Toral, F; Moya, D; Ruiz-Jimeno, A; Vila, I; Argyropoulos, T; Blanch Gutierrez, C; Boronat, M; Esperante, D; Faus-Golfe, A; Fuster, J; Fuster Martinez, N; Galindo Muñoz, N; García, I; Giner Navarro, J; Ros, E; Vos, M; Brenner, R; Ekelöf, T; Jacewicz, M; Ögren, J; Olvegård, M; Ruber, R; Ziemann, V; Aguglia, D; Alipour Tehrani, N; Aloev, A; Andersson, A; Andrianala, F; Antoniou, F; Artoos, K; Atieh, S; Ballabriga Sune, R; Barnes, M J; Barranco Garcia, J; Bartosik, H; Belver-Aguilar, C; Benot Morell, A; Bett, D R; Bettoni, S; Blanchot, G; Blanco Garcia, O; Bonnin, X A; Brunner, O; Burkhardt, H; Calatroni, S; Campbell, M; Catalan Lasheras, N; Cerqueira Bastos, M; Cherif, A; Chevallay, E; Constance, B; Corsini, R; Cure, B; Curt, S; Dalena, B; Dannheim, D; De Michele, G; De Oliveira, L; Deelen, N; Delahaye, J P; Dobers, T; Doebert, S; Draper, M; Duarte Ramos, F; Dubrovskiy, A; Elsener, K; Esberg, J; Esposito, M; Fedosseev, V; Ferracin, P; Fiergolski, A; Foraz, K; Fowler, A; Friebel, F; Fuchs, J-F; Fuentes Rojas, C A; Gaddi, A; Garcia Fajardo, L; Garcia Morales, H; Garion, C; Gatignon, L; Gayde, J-C; Gerwig, H; Goldblatt, A N; Grefe, C; Grudiev, A; Guillot-Vignot, F G; Gutt-Mostowy, M L; Hauschild, M; Hessler, C; Holma, J K; Holzer, E; Hourican, M; Hynds, D; Inntjore Levinsen, Y; Jeanneret, B; Jensen, E; Jonker, M; Kastriotou, M; Kemppinen, J M K; Kieffer, R B; Klempt, W; Kononenko, O; Korsback, A; Koukovini Platia, E; Kovermann, J W; Kozsar, C-I; Kremastiotis, I; Kulis, S; Latina, A; Leaux, F; Lebrun, P; Lefevre, T; Linssen, L; Llopart Cudie, X; Maier, A A; Mainaud Durand, H; Manosperti, E; Marelli, C; Marin Lacoma, E; Martin, R; Mazzoni, S; Mcmonagle, G; Mete, O; Mether, L M; Modena, M; Münker, R M; Muranaka, T; Nebot Del Busto, E; Nikiforou, N; Nisbet, D; Nonglaton, J-M; Nuiry, F X; Nürnberg, A; Olvegard, M; Osborne, J; Papadopoulou, S; Papaphilippou, Y; Passarelli, A; Patecki, M; Pazdera, L; Pellegrini, D; Pepitone, K; Perez, F; Perez Codina, E; Perez Fontenla, A; Persson, T H B; Petrič, M; Pitters, F; Pittet, S; Plassard, F; Rajamak, R; Redford, S; Renier, Y; Rey, S F; Riddone, G; Rinolfi, L; Rodriguez Castro, E; Roloff, P; Rossi, C; Rude, V; Rumolo, G; Sailer, A; Santin, E; Schlatter, D; Schmickler, H; Schulte, D; Shipman, N; Sicking, E; Simoniello, R; Skowronski, P K; Sobrino Mompean, P; Soby, L; Sosin, M P; Sroka, S; Stapnes, S; Sterbini, G; Ström, R; Syratchev, I; Tecker, F; Thonet, P A; Timeo, L; Timko, H; Tomas Garcia, R; Valerio, P; Vamvakas, A L; Vivoli, A; Weber, M A; Wegner, R; Wendt, M; Woolley, B; Wuensch, W; Uythoven, J; Zha, H; Zisopoulos, P; Benoit, M; Vicente Barreto Pinto, M; Bopp, M; Braun, H H; Csatari Divall, M; Dehler, M; Garvey, T; Raguin, J Y; Rivkin, L; Zennaro, R; Aksoy, A; Nergiz, Z; Pilicer, E; Tapan, I; Yavas, O; Baturin, V; Kholodov, R; Lebedynskyi, S; Miroshnichenko, V; Mordyk, S; Profatilova, I; Storizhko, V; Watson, N; Winter, A; Goldstein, J; Green, S; Marshall, J S; Thomson, M A; Xu, B; Gillespie, W A; Pan, R; Tyrk, M A; Protopopescu, D; Robson, A; Apsimon, R; Bailey, I; Burt, G; Constable, D; Dexter, A; Karimian, S; Lingwood, C; Buckland, M D; Casse, G; Vossebeld, J; Bosco, A; Karataev, P; Kruchinin, K; Lekomtsev, K; Nevay, L; Snuverink, J; Yamakawa, E; Boisvert, V; Boogert, S; Boorman, G; Gibson, S; Lyapin, A; Shields, W; Teixeira-Dias, P; West, S; Jones, R; Joshi, N; Bodenstein, R; Burrows, P N; Christian, G B; Gamba, D; Perry, C; Roberts, J; Clarke, J A; Collomb, N A; Jamison, S P; Shepherd, B J A; Walsh, D; Demarteau, M; Repond, J; Weerts, H; Xia, L; Wells, J D; Adolphsen, C; Barklow, T; Breidenbach, M; Graf, N; Hewett, J; Markiewicz, T; McCormick, D; Moffeit, K; Nosochkov, Y; Oriunno, M; Phinney, N; Rizzo, T; Tantawi, S; Wang, F; Wang, J; White, G; Woodley, M

2016-01-01

The Compact Linear Collider (CLIC) is a multi-TeV high-luminosity linear e+e- collider under development. For an optimal exploitation of its physics potential, CLIC is foreseen to be built and operated in a staged approach with three centre-of-mass energy stages ranging from a few hundred GeV up to 3 TeV. The first stage will focus on precision Standard Model physics, in particular Higgs and top-quark measurements. Subsequent stages will focus on measurements of rare Higgs processes, as well as searches for new physics processes and precision measurements of new states, e.g. states previously discovered at LHC or at CLIC itself. In the 2012 CLIC Conceptual Design Report, a fully optimised 3 TeV collider was presented, while the proposed lower energy stages were not studied to the same level of detail. This report presents an updated baseline staging scenario for CLIC. The scenario is the result of a comprehensive study addressing the performance, cost and power of the CLIC accelerator complex as a function of...

Classification, staging and radiotherapy of bronchial carcinoma

International Nuclear Information System (INIS)

Noordijk, E.M.

1983-01-01

This thesis reports a study performed to evaluate the stage classification of bronchial carcinoma published by Thomas in 1963. The study was done in the radiotherapy department of a teaching hospital, and had three parts: a comparative analysis of the classifications and stage divisions described in the literature on bronchial carcinoma; an evaluation of the theoretical basis of the classification system introduced by Thomas as well as of the practical applicability of the division into stages, with respect to the assessment of the prognosis and the choice of therapy; and an analysis of various aspects of irradiation as well as of a number of prognostic factors in bronchial carcinoma. (Auth.)

Deleterious effects of lymphocytes at the early stage of neurodegeneration in an animal model of amyotrophic lateral sclerosis

Directory of Open Access Journals (Sweden)

Nakatsuji Yuji

2011-02-01

Full Text Available Abstract Background Non-neuronal cells, such as microglia and lymphocytes, are thought to be involved in the pathogenesis of amyotrophic lateral sclerosis (ALS. Previous studies have demonstrated neuroprotective effects of lymphocytes at the end stage of ALS, partly through induction of alternatively activated microglia (M2 microglia, which are neuroprotective. In this study, we investigated the role of lymphocytes in the early stage of the disease using an animal model of inherited ALS. Methods We established a transgenic mouse line overexpressing the familial ALS-associated G93A-SOD1 mutation (harboring a single amino acid substitution of glycine to alanine at codon 93 with depletion of the Rag2 gene (mSOD1/RAG2-/- mice, an animal model of inherited ALS lacking mature lymphocytes. Body weights, clinical scores and motor performance (hanging wire test of mSOD1/RAG2-/- mice were compared to those of mutant human SOD1 transgenic mice (mSOD1/RAG2+/+ mice. Activation of glial cells in the spinal cords of these mice was determined immunohistochemically, and the expression of mRNA for various inflammatory and anti-inflammatory molecules was evaluated. Results Clinical onset in mSOD1/RAG2-/- mice was significantly delayed, and the number of lectin-positive cells in spinal cord was increased at the early stage of disease when compared to mSOD1/RAG2+/+ mice. Quantitative RT-PCR confirmed that mRNA for Ym1, an M2 microglial-related molecule, was significantly increased in mSOD1/RAG2-/- mouse spinal cords at the early disease stage. Conclusions Compared with mSOD1/RAG2+/+ mice, mSOD1/RAG2-/- mice displayed delayed onset and increased M2 microglial activation at the early stage of disease. Thus, lymphocytes at the early pathological phase of ALS display a deleterious effect via inhibition of M2 microglial activation.

Modeling the Hybrid Flow Shop Scheduling Problem Followed by an Assembly Stage Considering Aging Effects and Preventive Maintenance Activities

Directory of Open Access Journals (Sweden)

Seyyed Mohammad Hassan Hosseini

2016-05-01

Full Text Available Scheduling problem for the hybrid flow shop scheduling problem (HFSP followed by an assembly stage considering aging effects additional preventive and maintenance activities is studied in this paper. In this production system, a number of products of different kinds are produced. Each product is assembled with a set of several parts. The first stage is a hybrid flow shop to produce parts. All machines can process all kinds of parts in this stage but each machine can process only one part at the same time. The second stage is a single assembly machine or a single assembly team of workers. The aim is to schedule the parts on the machines and assembly sequence and also determine when the preventive maintenance activities get done in order to minimize the completion time of all products (makespan. A mathematical modeling is presented and its validation is shown by solving an example in small scale. Since this problem has been proved strongly NP-hard, in order to solve the problem in medium and large scale, four heuristic algorithms is proposed based on the Johnson’s algorithm. The numerical experiments are used to run the mathematical model and evaluate the performance of the proposed algorithms.

The development of an intervention to manage pain in people with late-stage osteoarthritis

Directory of Open Access Journals (Sweden)

Tina Kruger-Jakins

2016-06-01

Full Text Available Background: Osteoarthritis (OA is one of the most common musculoskeletal conditions worldwide, affecting the functional abilities of millions of people. Arthroplasty is recommended as a successful treatment option for late-stage OA. However, in South Africa there are extensive waiting lists for OA-related arthroplasty in government hospitals. This has negative consequences for patients having to cope for long periods of time with chronic pain and its impact. Alternative treatment methods in the form of physiotherapy-led exercise and education programmes focusing on pain, disability, self-efficacy, physical function and health-related quality of life have had good impact in populations elsewhere. Objectives: To develop an exercise and education intervention based on the current literature and by doing a field survey in a South African population. Results: A combined educational approach, with a strong focus on the physical aspects of exercise in particular, was adopted for the intervention in order to improve function and manage the disability associated with OA. Conclusion: This paper reports on the process and development of an intervention for use in South Africans with late-stage OA awaiting arthroplasty. Keywords: Hip/knee osteoarthritis, arthroplasty, joint replacement, bio-psychosocial intervention, waiting list, physiotherapy, exercise, education, chronic pain

Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System.

Science.gov (United States)

Edsberg, Laura E; Black, Joyce M; Goldberg, Margaret; McNichol, Laurie; Moore, Lynn; Sieggreen, Mary

Our understanding of pressure injury etiology and development has grown in recent years through research, clinical expertise, and global interdisciplinary expert collaboration. Therefore, the National Pressure Ulcer Advisory Panel (NPUAP) has revised the definition and stages of pressure injury. The revision was undertaken to incorporate the current understanding of the etiology of pressure injuries, as well as to clarify the anatomical features present or absent in each stage of injury. An NPUAP-appointed Task Force reviewed the literature and created drafts of definitions, which were then reviewed by stakeholders and the public, including clinicians, educators, and researchers around the world. Using a consensus-building methodology, these revised definitions were the focus of a multidisciplinary consensus conference held in April 2016. As a result of stakeholder and public input, along with the consensus conference, important changes were made and incorporated into the new staging definitions. The revised staging system uses the term injury instead of ulcer and denotes stages using Arabic numerals rather than Roman numerals. The revised definition of a pressure injury now describes the injuries as usually occurring over a bony prominence or under a medical or other device. The revised definition of a Stage 2 pressure injury seeks to clarify the difference between moisture-associated skin damage and injury caused by pressure and/or shear. The term suspected has been removed from the Deep Tissue Pressure Injury diagnostic label. Each definition now describes the extent of tissue loss present and the anatomical features that may or may not be present in the stage of injury. These important revisions reflect the methodical and collaborative approach used to examine the available evidence and incorporate current interdisciplinary clinical expertise into better defining the important phenomenon of pressure injury etiology and development.

Uterine cervical cancer. Preoperative staging with magnetic resonance imaging; Zervixkarzinom. Praeoperatives Staging mittels Magnetresonanztomographie

Energy Technology Data Exchange (ETDEWEB)

Collettini, F.; Hamm, B. [Charite-Universitaetsmedizin Berlin, Campus Charite Mitte, Klinik fuer Radiologie, Berlin (Germany)

2011-07-15

The treatment of uterine cervical carcinoma is largely dependent on the tumor stage. Despite significant inaccuracies in the clinical examination, uterine cervical cancer remains the only gynecological form of cancer still largely staged according to clinical findings. Although imaging is still not included in the staging the recently published revised FIGO (Federation International de Gynecologie et d'Obstetrique) system encourages the use of modern cross-sectional imaging (magnetic resonance imaging MRI and computed tomography CT). Due to its high soft tissue contrast MRI allows excellent non-invasive assessment of the cervix with direct tumor delineation as well as assessment of the prognosis based on morphological factors. Studies in the literature report an accuracy of 93% for MRI in the preoperative assessment of tumor size and in the differentiation of operable from advanced cervical cancer. Therefore MRI is considered to be the optimal modality for diagnostic evaluation starting from FIGO stage IB1, for radiation therapy planning, and for exclusion of recurrence in follow-up. In this paper we give an overview of the role of magnetic resonance imaging in preoperative staging of uterine cervical cancer. (orig.) [German] Die Therapieplanung beim Zervixkarzinom ist weitgehend von der Stadieneinteilung nach FIGO (Federation International de Gynecologie et d'Obstetrique) abhaengig, die trotz erheblicher Ungenauigkeiten bei der klinischen Stadieneinteilung weiterhin aufgrund klinischer Untersuchungsbefunde erfolgt. Obwohl bildgebende Verfahren nach wie vor fuer die Stadieneinteilung nicht vorgesehen sind, wird im kuerzlich erschienen revidierten Stagingsystem der FIGO zum ersten Mal die Verwendung moderner Schnittbilddiagnostik (MRT und CT) befuerwortet. Die MRT ermoeglicht dank ihres hohen Weichteilkontrasts ein ausgezeichnetes nichtinvasives Staging des Zervixkarzinoms mit direkter Tumordarstellung sowie einer Prognoseabschaetzung anhand

A dual-stage sodium thermal electrochemical converter (Na-TEC)

Science.gov (United States)

Limia, Alexander; Ha, Jong Min; Kottke, Peter; Gunawan, Andrey; Fedorov, Andrei G.; Lee, Seung Woo; Yee, Shannon K.

2017-12-01

The sodium thermal electrochemical converter (Na-TEC) is a heat engine that generates electricity through the isothermal expansion of sodium ions. The Na-TEC is a closed system that can theoretically achieve conversion efficiencies above 45% when operating between thermal reservoirs at 1150 K and 550 K. However, thermal designs have confined previous single-stage devices to thermal efficiencies below 20%. To mitigate some of these limitations, we consider dividing the isothermal expansion into two stages; one at the evaporator temperature (1150 K) and another at an intermediate temperature (650 K-1050 K). This dual-stage Na-TEC takes advantage of regeneration and reheating, and could be amenable to better thermal management. Herein, we demonstrate how the dual-stage device can improve the efficiency by up to 8% points over the best performing single-stage device. We also establish an application regime map for the single- and dual-stage Na-TEC in terms of the power density and the total thermal parasitic loss. Generally, a single-stage Na-TEC should be used for applications requiring high power densities, whereas a dual-stage Na-TEC should be used for applications requiring high efficiency.

Simultaneous specimen and stage cleaning device for analytical electron microscope

Science.gov (United States)

Zaluzec, Nestor J.

1996-01-01

An improved method and apparatus are provided for cleaning both a specimen stage, a specimen and an interior of an analytical electron microscope (AEM). The apparatus for cleaning a specimen stage and specimen comprising a plasma chamber for containing a gas plasma and an air lock coupled to the plasma chamber for permitting passage of the specimen stage and specimen into the plasma chamber and maintaining an airtight chamber. The specimen stage and specimen are subjected to a reactive plasma gas that is either DC or RF excited. The apparatus can be mounted on the analytical electron microscope (AEM) for cleaning the interior of the microscope.

Cervical Cancer Stage IA

Science.gov (United States)

... historical Searches are case-insensitive Cervical Cancer Stage IA Add to My Pictures View /Download : Small: 720x576 ... Large: 3000x2400 View Download Title: Cervical Cancer Stage IA Description: Stage IA1 and IA2 cervical cancer; drawing ...

Cervical Cancer Stage IIIA

Science.gov (United States)

... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IIIA Add to My Pictures View /Download : ... 1275x1275 View Download Large: 2550x2550 View Download Title: Cervical Cancer Stage IIIA Description: Stage IIIA cervical cancer; drawing ...

Cervical Cancer Stage IVA

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... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVA Add to My Pictures View /Download : ... 1575x1200 View Download Large: 3150x2400 View Download Title: Cervical Cancer Stage IVA Description: Stage IVA cervical cancer; drawing ...

Cervical Cancer Stage IVB

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... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IVB Add to My Pictures View /Download : ... 1200x1305 View Download Large: 2400x2610 View Download Title: Cervical Cancer Stage IVB Description: Stage IVB cervical cancer; drawing ...

Late-Stage Caregiving

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

Stages and Behaviors

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

Early-Stage Caregiving

Science.gov (United States)

... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

An unreliable group arrival queue with k stages of service, retrial under variant vacation policy

Science.gov (United States)

Radha, J.; Indhira, K.; Chandrasekaran, V. M.

2017-11-01

In this research work we considered repairable retrial queue with group arrival and the server utilize the variant vacations. A server gives service in k stages. Any arriving group of units finds the server free, one from the group entering the first stage of service and the rest are joining into the orbit. After completion of the i th stage of service, the customer may have the option to choose (i+1)th stage of service with probability θi , with probability pi may join into orbit as feedback customer or may leave the system with probability {q}i=≤ft\\{\\begin{array}{l}1-{p}i-{θ }i,i=1,2,\\cdots k-1\\ 1-{p}i,i=k\\end{array}\\right\\}. If the orbit is empty at the service completion of each stage service, the server takes modified vacation until at least one customer appears in the orbit on the server returns from a vacation. Busy server may get to breakdown and the service channel will fail for a short interval of time. By using the supplementary variable method, steady state probability generating function for system size, some system performance measures are discussed.

The Impact of Transport Time on Outcomes Following Evacuation from Point of Injury

Science.gov (United States)

2017-06-16

reasonable in relation to anticipated benefits and the importance of the knowledge that may reasonably be expected to result. The subject selection is...patients with traumatic injuries require urgent medical attention and expeditious evacuation to improve survival. Aeromedical evacuation platforms such as

Staging of Lung Cancer

Science.gov (United States)

... LUNG CANCER MINI-SERIES #2 Staging of Lung Cancer Once your lung cancer is diagnosed, staging tells you and your health care provider about ... at it under a microscope. The stages of lung cancer are listed as I, II, III, and IV ...

Cervical Cancer Stage IB

Science.gov (United States)

... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IB Add to My Pictures View /Download : ... 1613x1200 View Download Large: 3225x2400 View Download Title: Cervical Cancer Stage IB Description: Stage IB1 and IB2 cervical ...

Meta-analysis of Gaussian individual patient data: Two-stage or not two-stage?

Science.gov (United States)

Morris, Tim P; Fisher, David J; Kenward, Michael G; Carpenter, James R

2018-04-30

Quantitative evidence synthesis through meta-analysis is central to evidence-based medicine. For well-documented reasons, the meta-analysis of individual patient data is held in higher regard than aggregate data. With access to individual patient data, the analysis is not restricted to a "two-stage" approach (combining estimates and standard errors) but can estimate parameters of interest by fitting a single model to all of the data, a so-called "one-stage" analysis. There has been debate about the merits of one- and two-stage analysis. Arguments for one-stage analysis have typically noted that a wider range of models can be fitted and overall estimates may be more precise. The two-stage side has emphasised that the models that can be fitted in two stages are sufficient to answer the relevant questions, with less scope for mistakes because there are fewer modelling choices to be made in the two-stage approach. For Gaussian data, we consider the statistical arguments for flexibility and precision in small-sample settings. Regarding flexibility, several of the models that can be fitted only in one stage may not be of serious interest to most meta-analysis practitioners. Regarding precision, we consider fixed- and random-effects meta-analysis and see that, for a model making certain assumptions, the number of stages used to fit this model is irrelevant; the precision will be approximately equal. Meta-analysts should choose modelling assumptions carefully. Sometimes relevant models can only be fitted in one stage. Otherwise, meta-analysts are free to use whichever procedure is most convenient to fit the identified model. © 2018 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd.

Driving in Early-Stage Alzheimer's Disease: An Integrative Review of the Literature.

Science.gov (United States)

Davis, Rebecca L; Ohman, Jennifer M

2017-03-01

One of the most difficult decisions for individuals with Alzheimer's disease (AD) is when to stop driving. Because driving is a fundamental activity linked to socialization, independent functioning, and well-being, making the decision to stop driving is not easy. Cognitive decline in older adults can lead to getting lost while driving, difficulty detecting and avoiding hazards, as well as increased errors while driving due to compromised judgment and difficulty in making decisions. The purpose of the current literature review was to synthesize evidence regarding how individuals with early-stage AD, their families, and providers make determinations about driving safety, interventions to increase driving safety, and methods to assist cessation and coping for individuals with early-stage AD. The evidence shows that changes in driving ability start early and progress throughout the trajectory of AD. Some individuals with mild cognitive impairment or early-stage AD may be safe to drive for a period of time. Support groups aimed at helping with the transition have been shown to be helpful for individuals who stop driving. Research and practice must support interventions to help individuals maintain safety while driving, as well as cope with driving cessation. [Res Gerontol Nurs. 2017; 10(2):86-100.]. Copyright 2016, SLACK Incorporated.

Recommendations for neoadjuvant pathologic staging (ypTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals.

Science.gov (United States)

Rice, Thomas W; Ishwaran, Hemant; Kelsen, David P; Hofstetter, Wayne L; Apperson-Hansen, Carolyn; Blackstone, Eugene H

2016-11-01

We report analytic and consensus processes that produced recommendations for neoadjuvant pathologic stage groups (ypTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration provided data for 22,654 patients with epithelial esophageal cancers; 7,773 had pathologic assessment after neoadjuvant therapy. Risk-adjusted survival for each patient was developed. Random forest analysis identified data-driven neoadjuvant pathologic stage groups wherein survival decreased monotonically with increasing group, was distinctive between groups, and homogeneous within groups. An additional analysis produced data-driven anatomic neoadjuvant pathologic stage groups based only on ypT, ypN, and ypM categories. The AJCC Upper GI Task Force, by smoothing, simplifying, expanding, and assessing clinical applicability, produced consensus neoadjuvant pathologic stage groups. Grade and location were much less discriminating for stage grouping ypTNM than pTNM. Data-driven stage grouping without grade and location produced nearly identical groups for squamous cell carcinoma and adenocarcinoma. However, ypTNM groups and their associated survival differed from pTNM. The need for consensus process was minimal. The consensus groups, identical for both cell types were as follows: ypStage I comprised ypT0-2N0M0; ypStage II ypT3N0M0; ypStage IIIA ypT0-2N1M0; ypStage IIIB ypT3N1M0, ypT0-3N2, and ypT4aN0M0; ypStage IVA ypT4aN1-2, ypT4bN0-2, and ypTanyN3M0; and ypStage IVB ypTanyNanyM1. Absence of equivalent pathologic (pTNM) categories for the peculiar neoadjuvant pathologic categories ypTisN0-3M0 and ypT0N0-3M0, dissimilar stage group compositions, and markedly different early- and intermediate-stage survival necessitated a unified, unique set of stage grouping for patients of either cell type who receive neoadjuvant therapy. © 2016 International Society for Diseases of the Esophagus.

Stages as models of scene geometry.

Science.gov (United States)

Nedović, Vladimir; Smeulders, Arnold W M; Redert, André; Geusebroek, Jan-Mark

2010-09-01

Reconstruction of 3D scene geometry is an important element for scene understanding, autonomous vehicle and robot navigation, image retrieval, and 3D television. We propose accounting for the inherent structure of the visual world when trying to solve the scene reconstruction problem. Consequently, we identify geometric scene categorization as the first step toward robust and efficient depth estimation from single images. We introduce 15 typical 3D scene geometries called stages, each with a unique depth profile, which roughly correspond to a large majority of broadcast video frames. Stage information serves as a first approximation of global depth, narrowing down the search space in depth estimation and object localization. We propose different sets of low-level features for depth estimation, and perform stage classification on two diverse data sets of television broadcasts. Classification results demonstrate that stages can often be efficiently learned from low-dimensional image representations.

Ovarian Cancer Stage IIIC

Science.gov (United States)

... Stage IIIC Description: Drawing of stage IIIC shows cancer inside both ovaries that has spread to the omentum. The cancer ... lymph nodes behind the peritoneum. In stage IIIC, cancer is found in one or both ovaries or fallopian tubes and has spread to the ...

High cost of stage IV pressure ulcers.

Science.gov (United States)

Brem, Harold; Maggi, Jason; Nierman, David; Rolnitzky, Linda; Bell, David; Rennert, Robert; Golinko, Michael; Yan, Alan; Lyder, Courtney; Vladeck, Bruce

2010-10-01

The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and analyzed. Costs directly related to the treatment of pressure ulcers and their associated complications were calculated. Nineteen patients with stage IV pressure ulcers (11 hospital-acquired and 8 community-acquired) were identified and their charts were reviewed. The average hospital treatment cost associated with stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers during 1 admission, and $124,327 for community-acquired ulcers over an average of 4 admissions. The costs incurred from stage IV pressure ulcers are much greater than previously estimated. Halting the progression of early stage pressure ulcers has the potential to eradicate enormous pain and suffering, save thousands of lives, and reduce health care expenditures by millions of dollars. Copyright © 2010 Elsevier Inc. All rights reserved.

Breast cancer staging

Science.gov (United States)

... this page: //medlineplus.gov/ency/patientinstructions/000911.htm Breast cancer staging To use the sharing features on this ... Once your health care team knows you have breast cancer , they will do more tests to stage it. ...

Multi-stage continuous alcohol fermentation with cane molasses

Energy Technology Data Exchange (ETDEWEB)

Chu, C J; Chiou, C J; Ng, A K; Lin, T C; Hwang, E C; Rao, C H

1970-01-01

It was reported that 6 to 7% ethanol was produced by single-stage continuous 12-hour cycle fermentation of molasses containing 12% sugar using a new strain, Saccharomyces formensensis, isolated from a stock culture. A higher yield of ethanol was obtained from 2-stage and 3-stage continuous fermentation of molasses containing more sugar at 24- and 36-hour cycles, respectively. In the 2-stage 24-hour cycle continuous fermentation of molasses containing 15% sugar with an agitation speed 300 rpm, 9.2% ethanol resulted. Only 3% sugar remained unconsumed. In the 3-stage 36-hour cycle continuous fermentation of molasses containing 15% sugar with 300 rpm agitation, 12.5% ethanol resulted.

Staging for vulvar cancer.

Science.gov (United States)

Hacker, Neville F; Barlow, Ellen L

2015-08-01

Vulvar cancer has been staged by the International Federation of Gynaecology and Obstetrics (FIGO) since 1969, and the original staging system was based on clinical findings only. This system provided a very good spread of prognostic groupings. Because vulvar cancer is virtually always treated surgically, the status of the lymph nodes is the most important prognostic factor and this can only be determined with certainty by histological examination of resected lymph nodes, FIGO introduced a surgical staging system in 1988. This was modified in 1994 to include a category of microinvasive vulvar cancer (stage IA), because such patients have virtually no risk of lymph node metastases. This system did not give a reasonably even spread of prognostic groupings. In addition, patients with stage III disease were shown to be a heterogeneous group prognostically, and the number of positive nodes and the morphology of those nodes were not taken into account. A new surgical staging system for vulvar cancer was introduced by FIGO in 2009. Initial retrospective analyses have suggested that this new staging system has overcome the major deficiencies in the 1994 system. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Second-stage primary Caesarean deliveries: Are maternal ...

African Journals Online (AJOL)

variables were nonsignificant. None of the women or their babies needed readmission to hospital or transfer to an intensive care unit. Table I: Demographic data of mother and neonate following Caesarean delivery in the first and second stages of labour. Demographics. Caesarean delivery 2nd stage (n = 53). Caesarean.

Development of an axially staged annular combustor with low residence times in the main stage. Final report; Entwicklung eines gestuften Brenners in Ringanordnung mit kleiner Aufenthaltszeit in der Hauptzone. Abschlussbericht

Energy Technology Data Exchange (ETDEWEB)

Bauer, H.J. [BMW Rolls-Royce GmbH, Dahlewitz (Germany). Abt. Brennkammerentwicklung; Theisen, D. [Technische Univ. Muenchen (Germany). Lehrstuhl fuer Flugantriebe

1998-05-28

Within the project presented an axially staged annular combustor has been investigated. Staged combustion significantly reduces emissions of nitrogen oxide without sacrifying combustion efficiency and stability during low power conditions. The cold flow in the combustion module was analysed in water analogy tests. Stability of the main fuel injectors was investigated in a low pressure sector rig, high pressure tests were focused on nitric oxides and smoke emissions and on the detection of the temperature pattern at the combustor exit. Based on these results a second configuration was derived. Improved mixing of the pilot stage exhaust gases into the primary zone of the main stage was achieved. This configuration revealed a considerable reduction of nitric oxide emissions as well as a more even exit temperature pattern. The aerothermal design and optimisation of the staged combustor and the interpretation of the experimental results were supported by means of CFD calculations. The accuracy of the prediction of pollutant emissions could be enhanced by the incorporation of an advanced laminar-flamelet combustion model. Fuel/air mixing as well as the combustion process were investigated in a planar model of the staged combustor at LFA, University of Munich, by means of laser-spectroscopic methods. Under atmospheric conditions 2D concentrations of OH, O{sub 2}, and NO were measured. Characteristic differences of the combustion process for the staged and unstaged mode, respectively, were detected. The general applicability of planar temperature measurement by means of `2 lines thermometry` could be demonstrated. (orig.) [Deutsch] Im Rahmen des hier vorgestellten Vorhabens wurde eine axial gestufte Ringbrennkammer untersucht, die eine deutliche Senkung der Stickoxidemissionen bewirkt, ohne den Ausbrand und die Stabilitaet im unteren Lastbereich zu verschlechtern. In Wasseranalogieversuchen wurde die kalte Stroemung analysiert und optimiert. Die Stabilitaet der

Stages of change and health-related quality of life among employees of an institution.

Science.gov (United States)

Liau, Siow Yen; Shafie, Asrul A; Ibrahim, Mohamed Izham Mohamed; Hassali, Mohamed Azmi; Othman, Ahmad Tajuddin; Mohamed, Mohamad Haniki Nik; Hamdi, Menal A

2013-06-01

Transtheoretical Model of change has been used successfully in promoting behaviour change. To examine the relationships between health-related quality of life (HRQoL) scores with the stages of change of adequate physical activity and fruit and vegetables intake. This was a cross-sectional study conducted among employees of the main campus and Engineering campus of Universiti Sains Malaysia (USM) during October 2009 and March 2010. Data on physical activity and fruit and vegetable intake was collected using the WHO STEPS instrument for chronic disease risk factors surveillance. The Short Form-12 health survey (SF-12) was used to gather information on participants' HRQoL. The current stages of change are measured using the measures developed by the Pro-Change Behaviour Systems Incorporation. One way ANOVA and its non-parametric equivalent Kruskal-Wallis were used to compare the differences between SF-12 scores with the stages of change. A total of 144 employees were included in this analysis. A large proportion of the participants reported inadequate fruits and vegetable intake (92.3%) and physical activity (84.6%). Mean physical and mental component scores of SF-12 were 50.39 (SD = 7.69) and 49.73 (SD = 8.64) respectively. Overall, there was no statistical significant difference in the SF-12 domains scores with regards to the stages of change for both the risk factors. There were some evidence of positive relationship between stages of change of physical activity and fruit and vegetable intake with SF-12 scores. Further studies need to be conducted to confirm this association. © 2011 John Wiley & Sons Ltd.

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.

AEROMEDICAL EVACUATION: CLINICALLY PREPARING AIR FORCE FLIGHT NURSES

Science.gov (United States)

2016-10-10

clinical simulation (VCS) technology is another resource educators are experimenting with. “Also known as three-dimensional virtual worlds, serious...have a variety of diseases and injuries. Many combat related injuries are severe and complex. Nurses are often the mostly highly educated medical...made this vision a reality . Using aircraft to transport patients became an airlift capability that is now an Air Force responsibility. The current

Baseline characteristics of patients with chronic kidney disease stage 3 and stage 4 in spain: the MERENA observational cohort study

Directory of Open Access Journals (Sweden)

Montes Rafael

2011-10-01

Full Text Available Abstract Background To obtain information on cardiovascular morbidity, hypertension control, anemia and mineral metabolism based on the analysis of the baseline characteristics of a large cohort of Spanish patients enrolled in an ongoing prospective, observational, multicenter study of patients with stages 3 and 4 chronic kidney diseases (CKD. Methods Multicenter study from Spanish government hospital-based Nephrology outpatient clinics involving 1129 patients with CKD stages 3 (n = 434 and 4 (n = 695 defined by GFR calculated by the MDRD formula. Additional analysis was performed with GFR calculated using the CKD-EPI and Cockcroft-Gault formula. Results In the cohort as a whole, median age 70.9 years, morbidity from all cardiovascular disease (CVD was very high (39.1%. In CKD stage 4, CVD prevalence was higher than in stage 3 (42.2 vs 35.6% p 300 mg/day was present in more than 60% of patients and there was no significant differences between stages 3 and 4 CKD (1.2 ± 1.8 and 1.3 ± 1.8 g/day, respectively. A majority of the patients had hemoglobin levels greater than 11 g/dL (91.1 and 85.5% in stages 3 and 4 CKD respectively p Conclusion This study provides an overview of key clinical parameters in patients with CKD Stages 3 and 4 where delivery or care was largely by nephrologists working in a network of hospital-based clinics of the Spanish National Healthcare System.

Preoperative staging of lung cancer with combined PET-CT

DEFF Research Database (Denmark)

Fischer, Barbara; Lassen, Ulrik; Mortensen, Jann

2009-01-01

BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC...... one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause...

Neurology cases evaluated by the U.S. Air Force School of Aerospace Medicine 2000-2012.

Science.gov (United States)

Hesselbrock, Roger; Heaton, John

2014-05-01

Historically, neurologic conditions are a major cause for removing aviators from flying status. Early neuropsychiatry studies included psychiatric conditions along with neurologic disorders. Previously reported data specifically addressing neurologic conditions in aviators are limited. And there is little current neurology-specific data reported. A retrospective review was done on patients with diagnoses evaluated by Neurology at the U.S. Air Force School of Aerospace Medicine Aeromedical Consultation Service (ACS) between 2000 and 2012 using ACS records and databases to identify cases. Patient demographics, major diagnoses with associated International Classification of Diseases (9th rev.) codes, and aeromedical disposition recommendations were abstracted into a separate database for analysis. In total, 871 cases were identified. Patients were predominantly male (91%) with average age 34 and were predominantly pilots (69%). The top neurology-related diagnoses found in our series were headaches, head injuries, and radiculopathies. Of the cases evaluated, 570 aviators (65%) were recommended by ACS to return to flying status. Waiver authorities accepted 88% of ACS recommendations. Current patterns in neurologic conditions in the selected population of cases evaluated by the ACS were presented. Of the neurologic diagnoses seen, a novel finding was the prominence of head injuries in our series not seen in previous studies. This may be due to more stringent aeromedical standards with advances in medical practice and underscores that this issue is not just about disability but affects aircrew operational readiness. Most cases of neurologic disease evaluated by the ACS were recommended for return to flying status.

Simplified Multi-Stage and Per Capita Convergence: an analysis of two climate regimes for differentiation of commitments

NARCIS (Netherlands)

Elzen MGJ den; Berk MM; Lucas P; KMD

2004-01-01

This report describes and analyses in detail two climate regimes for differentiating commitments: the simplified Multi-Stage and Per Capita Convergence approaches. The Multi-Stage approach consists of a system to divide countries into groups with different types of commitments (stages). The Per

Hormesis and stage specific toxicity induced by cadmium in an insect model, the queen blowfly, Phormia regina Meig

Energy Technology Data Exchange (ETDEWEB)

Nascarella, Marc A.; Stoffolano, John G.; Stanek, Edward J.; Kostecki, Paul T.; Calabrese, Edward J

2003-07-01

This is the first report of a heavy metal displaying a hormetic-like biphasic response for early developmental success, while at the same time displaying stage-specific toxicity at a later developmental stage. - Hormesis is an adaptive response, commonly characterized by a biphasic dose-response that can be either directly induced, or the result of compensatory biological processes following an initial disruption in homeostasis [Calabrese and Baldwin, Hum. Exp. Toxicol., 21 (2002), 91]. Low and environmentally relevant levels of dietary cadmium significantly enhanced the pupation rate of blowfly larvae, while higher doses inhibited pupation success. However, dietary cadmium at all exposure levels adversely affected the emergence of the adult fly from the pupal case. Such findings represent the first report of a heavy metal displaying a hormetic-like biphasic response for pupation success, while at the same time displaying stage-specific toxicity at a later developmental period. These conclusions are based on substantial experimentation of over 1750 blowflies, in seven replicate experiments, involving 10 concentrations per experiment. These findings indicate the need to assess the impact of environmental stressors over a broad range of potential exposures as well as throughout the entire life cycle.

Hormesis and stage specific toxicity induced by cadmium in an insect model, the queen blowfly, Phormia regina Meig

International Nuclear Information System (INIS)

Nascarella, Marc A.; Stoffolano, John G.; Stanek, Edward J.; Kostecki, Paul T.; Calabrese, Edward J.

2003-01-01

This is the first report of a heavy metal displaying a hormetic-like biphasic response for early developmental success, while at the same time displaying stage-specific toxicity at a later developmental stage. - Hormesis is an adaptive response, commonly characterized by a biphasic dose-response that can be either directly induced, or the result of compensatory biological processes following an initial disruption in homeostasis [Calabrese and Baldwin, Hum. Exp. Toxicol., 21 (2002), 91]. Low and environmentally relevant levels of dietary cadmium significantly enhanced the pupation rate of blowfly larvae, while higher doses inhibited pupation success. However, dietary cadmium at all exposure levels adversely affected the emergence of the adult fly from the pupal case. Such findings represent the first report of a heavy metal displaying a hormetic-like biphasic response for pupation success, while at the same time displaying stage-specific toxicity at a later developmental period. These conclusions are based on substantial experimentation of over 1750 blowflies, in seven replicate experiments, involving 10 concentrations per experiment. These findings indicate the need to assess the impact of environmental stressors over a broad range of potential exposures as well as throughout the entire life cycle

Early stage design and analysis of biorefinery networks

DEFF Research Database (Denmark)

Sin, Gürkan

2013-01-01

Recent work regarding biorefineries resulted in many competing concepts and technologies for conversion of renewable bio-based feedstock into many promising products including fuels, chemicals, materials, etc. The design of a biorefinery process requires, at its earlier stages, the selection...... of the process configuration which exhibits the best performances, for a given set of economical, technical and environmental criteria. To this end, we formulate a computer-aided framework as an enabling technology for early stage design and analysis of biorefineries. The tool represents different raw materials......, different products and different available technologies and proposes a conceptual (early stage) biorefinery network. This network can then be the basis for further detailed and rigorous model-based studies. In this talk, we demonstrate the application of the tool for generating an early stage optimal...

[Comparison research on two-stage sequencing batch MBR and one-stage MBR].

Science.gov (United States)

Yuan, Xin-Yan; Shen, Heng-Gen; Sun, Lei; Wang, Lin; Li, Shi-Feng

2011-01-01

Aiming at resolving problems in MBR operation, like low nitrogen and phosphorous removal efficiency, severe membrane fouling and etc, comparison research on two-stage sequencing batch MBR (TSBMBR) and one-stage aerobic MBR has been done in this paper. The results indicated that TSBMBR owned advantages of SBR in removing nitrogen and phosphorous, which could make up the deficiency of traditional one-stage aerobic MBR in nitrogen and phosphorous removal. During steady operation period, effluent average NH4(+) -N, TN and TP concentration is 2.83, 12.20, 0.42 mg/L, which could reach domestic scenic environment use. From membrane fouling control point of view, TSBMBR has lower SMP in supernatant, specific trans-membrane flux deduction rate, membrane fouling resistant than one-stage aerobic MBR. The sedimentation and gel layer resistant of TSBMBR was only 6.5% and 33.12% of one-stage aerobic MBR. Besides high efficiency in removing nitrogen and phosphorous, TSBMBR could effectively reduce sedimentation and gel layer pollution on membrane surface. Comparing with one-stage MBR, TSBMBR could operate with higher trans-membrane flux, lower membrane fouling rate and better pollutants removal effects.

Labor Union Effects on Innovation and Commercialization Productivity: An Integrated Propensity Score Matching and Two-Stage Data Envelopment Analysis

Directory of Open Access Journals (Sweden)

Dongphil Chun

2015-04-01

Full Text Available Research and development (R&D is a critical factor in sustaining a firm’s competitive advantage. Accurate measurement of R&D productivity and investigation of its influencing factors are of value for R&D productivity improvements. This study is divided into two sections. The first section outlines the innovation and commercialization stages of firm-level R&D activities. This section analyzes the productivity of each stage using a propensity score matching (PSM and two-stage data envelopment analysis (DEA integrated model to solve the selection bias problem. Second, this study conducts a comparative analysis among subgroups categorized as labor unionized or non-labor unionized on productivity at each stage. We used Korea Innovation Survey (KIS data for analysis using a sample of 400 Korean manufacturers. The key findings of this study include: (1 firm innovation and commercialization productivity are balanced and show relatively low innovation productivity; and (2 labor unions have a positive effect on commercialization productivity. Moreover, labor unions are an influential factor in determining manufacturing firms’ commercialization productivity.

Modeling of existing cooling towers in ASPEN PLUS using an equilibrium stage method

International Nuclear Information System (INIS)

Queiroz, João A.; Rodrigues, Vitor M.S.; Matos, Henrique A.; Martins, F.G.

2012-01-01

Highlights: ► Simulation of cooling tower performance under different operating conditions. ► Cooling tower performance is simulated using ASPEN PLUS. ► Levenberg–Marquardt method used to adjust model parameters. ► Air and water outlet temperatures are in good accordance with experimental data. - Abstract: Simulation of cooling tower performance considering operating conditions away from design is typically based on the geometrical parameters provided by the cooling tower vendor, which are often unavailable or outdated. In this paper a different approach for cooling tower modeling based on equilibrium stages and Murphree efficiencies to describe heat and mass transfer is presented. This approach is validated with published data and with data collected from an industrial application. Cooling tower performance is simulated using ASPEN PLUS. Murphree stage efficiency values for the process simulator model were optimized by minimizing the squared difference between the experimental and calculated data using the Levenberg–Marquardt method. The minimization algorithm was implemented in Microsoft Excel with Visual Basic for Applications, integrated with the process simulator (ASPEN PLUS) using Aspen Simulation Workbook. The simulated cooling tower air and water outlet temperatures are in good accordance with experimental data when applying only the outlet water temperature to calibrate the model. The methodology is accurate for simulating cooling towers at different operational conditions.

Multiple factors influence compliance with colorectal cancer staging recommendations: an exploratory study

Directory of Open Access Journals (Sweden)

Khalifa Mahmoud A

2008-02-01

Full Text Available Abstract Background For patients with colorectal cancer (CRC retrieval by surgeons, and assessment by pathologists of at least 12 lymph nodes (LNs predicts the need for adjuvant treatment and improved survival. Different interventions (educational presentation, engaging clinical opinion leaders, performance data sent to hospital executives to improve compliance with this practice had variable results. This exploratory study examined factors hypothesized to have influenced the outcome of those interventions. Methods Semi-structured interviews were conducted with 26 surgeons and pathologists at eleven hospitals. Clinicians were identified by intervention organizers, public licensing body database, and referral from interviewees. An interview guide incorporating open-ended questions was pilot-tested on one surgeon and pathologist. A single investigator conducted all interviews by phone. Transcripts were analyzed independently by two investigators using a grounded approach,ho then compared findings to resolve differences. Results Improvements in LN staging practice may have occurred largely due to educational presentations that created awareness, and self-initiated changes undertaken by pathologists. Executives that received performance data may not have shared this with staff, and opinion leaders engaged to promote compliance may not have fulfilled their roles. Barriers to change that are potentially amenable to quality improvement included perceptions about the practice (perceived lack of evidence for the need to examine at least 12 LNs and associated responsibilities (blaming other profession, technical issues (need for pathology assistants, better clearing solutions and laboratory facilities, and a lack of organizational support for multidisciplinary interaction (little communication between surgeons and pathologists or quality improvement (no change leaders or capacity for monitoring. Conclusion Use of an exploratory approach provided an in

An Approach to Mapping Forest Growth Stages in Queensland, Australia through Integration of ALOS PALSAR and Landsat Sensor Data

Directory of Open Access Journals (Sweden)

João Carreiras

2012-08-01

Full Text Available Whilst extensive clearance of forests in the eastern Australian Brigalow Belt Bioregion (BBB has occurred since European settlement, appropriate management of those that are regenerating can facilitate restoration of biomass (carbon and biodiversity to levels typical of relatively undisturbed or remnant formations. However, maps of forests are different stages of regeneration are needed to facilitate restoration planning, including prevention of further re-clearing. Focusing on the Tara Downs subregion of the BBB and on forests with brigalow (Acacia harpophylla as a component, this research establishes a method for differentiating and mapping early, intermediate and remnant growth stages from Japan Aerospace Exploration Agency (JAXA Advanced Land Observing Satellite (ALOS Phased-Array L-band Synthetic Aperture Radar (PALSAR Fine Beam Dual (FBD L-band HH- and HV-polarisation backscatter and Landsat-derived Foliage Projective Cover (FPC. Using inventory data collected from 74 plots, located in the Tara Downs subregion, forests were assigned to one of three regrowth stages based on their height and cover relative to that of undisturbed stands. The image data were then segmented into objects with each assigned to a growth stage by comparing the distributions of L-band HV and HH polarisation backscatter and FPC to that of reference distributions using a z-test. Comparison with independent assessments of growth stage, based on time-series analysis of aerial photography and SPOT images, established an overall accuracy of > 70%, with this increasing to 90% when intermediate regrowth was excluded and only early-stage regrowth and remnant classes were considered. The proposed method can be adapted to respond to amendments to user-definitions of growth stage and, as regional mosaics of ALOS PALSAR and Landsat FPC are available for Queensland, has application across the state.

Summary Staging Manual 2000 - SEER

Science.gov (United States)

Access this manual of codes and coding instructions for the summary stage field for cases diagnosed 2001-2017. 2000 version applies to every anatomic site. It uses all information in the medical record. Also called General Staging, California Staging, and SEER Staging.

Pleural lavage cytology as an independent prognostic factor in non-small-cell lung cancer patients with stage I disease and adenocarcinoma.

Science.gov (United States)

Hokka, Daisuke; Uchino, Kazuya; Tane, Kenta; Ogawa, Hiroyuki; Tane, Sinya; Tanaka, Yugo; Tauchi, Shunsuke; Nishio, Wataru; Yoshimura, Masahiro; Maniwa, Yoshimasa

2015-01-01

We previously reported that cancer cells may be detected through pleural lavage cytology (PLC). In this study, we sought to re-examine the prognostic significance of the PLC status based on an extended dataset with an additional follow-up period. Pleural lavage following thoracotomy was cytologically examined in 1,317 consecutive patients who were diagnosed with NSCLC between 1987 and 2004 at the Thoracic Surgery Units of Kobe University Graduate School of Medicine and Hyogo Cancer Center. Among the investigated patients, 46 exhibited positive cytological findings. The prognosis of these patients was significantly worse compared to that of patients without positive PLC. Of the 844 pathological stage I patients, 18 had a positive PLC status and their prognosis was significantly worse compared to that of patients with stage I disease without positive PLC. In conclusion, positive PLC findings were associated with a poor prognosis and this finding was significant for patients with stage I disease. These results suggest the need for PLC status evaluation during staging and treatment planning in patients with NSCLC.

A Novel Dual-Stage Hydrothermal Flow Reactor

DEFF Research Database (Denmark)

Hellstern, Henrik Christian; Becker, Jacob; Hald, Peter

2015-01-01

The dual-stage reactor is a novel continuous flow reactor with two reactors connected in series. It is designed for hydrothermal flow synthesis of nanocomposites, in which a single particle consists of multiple materials. The secondary material may protect the core nanoparticle from oxidation....... The dual-stage reactor combines the ability to produce advanced materials with an upscaled capacity in excess of 10 g/hour (dry mass). TiO2 was synthesized in the primary reactor and reproduced previous results. The dual-stage capability was succesfully demonstrated with a series of nanocomposites incl. Ti...

Two-stage thermal/nonthermal waste treatment process

International Nuclear Information System (INIS)

Rosocha, L.A.; Anderson, G.K.; Coogan, J.J.; Kang, M.; Tennant, R.A.; Wantuck, P.J.

1993-01-01

An innovative waste treatment technology is being developed in Los Alamos to address the destruction of hazardous organic wastes. The technology described in this report uses two stages: a packed bed reactor (PBR) in the first stage to volatilize and/or combust liquid organics and a silent discharge plasma (SDP) reactor to remove entrained hazardous compounds in the off-gas to even lower levels. We have constructed pre-pilot-scale PBR-SDP apparatus and tested the two stages separately and in combined modes. These tests are described in the report

The risks, needs and stages of recovery of a complete forensic patient cohort in an Australian state.

Science.gov (United States)

Adams, Jonathon; Thomas, Stuart D M; Mackinnon, Tobias; Eggleton, Damien

2018-02-07

Routine outcome measures are increasingly being mandated across mental health services in Australia and overseas. This requirement includes forensic mental health services, but their utility in such specialist services and the inter-relationships between the measures remain unclear. This study sought to characterise the risks, needs and stages of recovery of an entire cohort of forensic patients in one jurisdiction in Australia. Local expert groups, comprising of members of the forensic patient treating teams, were formed to gather information about the status and needs of all forensic patients in the State of New South Wales, Australia. The expert groups provided demographic information and completed three assessment tools concerning the risks, needs and stages of recovery of each forensic patient. The cohort of 327 forensic patients in NSW appears to be typical of forensic mental health service populations internationally when considering factors such as gender, diagnosis, and index offence. A number of important differences across the three structured tools for forensic patients in different levels of secure service provision are presented. The DUNDRUM Quartet demonstrated interesting findings, particularly in terms of the therapeutic security needs, the treatment completion, and the stages of recovery for the forensic patients in the community. The CANFOR highlighted the level of needs across the forensic patient population, whilst the HCR-20 data showed there was no significant difference in the mean clinical and risk management scores between male forensic patients across levels of security. To the authors' knowledge this is the first study of its kind in New South Wales, Australia. We have demonstrated the utility of using a suite of measures to evaluate the risks, needs, and stages of recovery for an entire cohort of forensic patients. The data set helps inform service planning and development, together with providing various avenues for future research.

Manned-Unmanned Teaming: Expanding the Envelope of UAS Operational Employment (Reprint)

Science.gov (United States)

2014-11-01

Orders will be expedited if placed through the librarian or other person designated to request documents from DTIC. Change of Address Organizations...within the domain of the aeromedical community. There are many lines of scientifi c inves- tigation among multiple consortia of research entities

DIFFICULTIES IN DETERMINING THE STAGE OF PROSTATE CANCER

Directory of Open Access Journals (Sweden)

I. V. Lukianov

2014-07-01

Full Text Available The choice of a technique of treatment of prostate cancer depends on the age of the patient, accompanying diseases and prevalence of tumoral process. The basic methods at an inspection stage at which the cancer stage is defined are: definition of prostate specific membrane antigen, rectal examination, results of the rectal ultrasound guided biopsy, prostate imaging methods and an estimation of a grade of a tumor. Nowadays one of the main directions of determining the treatment for various stages of tumor is the development of prognostic models based on the analysis of predictors for tumor expansion.

Two-stage dental implants inserted in a one-stage procedure : a prospective comparative clinical study

NARCIS (Netherlands)

Heijdenrijk, Kees

2002-01-01

The results of this study indicate that dental implants designed for a submerged implantation procedure can be used in a single-stage procedure and may be as predictable as one-stage implants. Although one-stage implant systems and two-stage.

An initial report of cyberknife radiosurgery treatment in early stage lung cancer

International Nuclear Information System (INIS)

Yuan Zhiyong; Song Yongchun; Li Fengtong; Dong Yang; Wang Jingsheng; Wang Jun; Wang Changli; Wang Ping

2008-01-01

Objective: To study the efficacy and toxicity of the cyberknife in the treatment of medically inoperable patients with early stage lung cancer. Methods: From September 2006 to July 2007,17 patients with clinical stage I a-I b lung cancer were treated with cyberknife at Tianjin Cancer Hospital. Of the 11 patients receiving CT guided biopsy, 3 were squamous cell cancer and 8 were adenocarcinoma. Six patients refused intrusive operation and were diagnosed by PET-CT scan. All patients were medically inoperable evaluated by a thoracic surgeon. The PTV=GTV + 3-5 mm, and the median volume of PTV was 36 cm 3 (6-82 cm 3 ). The median total prescription dose was 50 Gy(45-60 Gy) at 3-5 fractions. Results: The median follow-up time was 7 months(3-11 months). All the patients finished the treatment and were alive by the last follow-up. Slight fatigue was the most common complain. Evaluated by CT scan, 13 were complete response and 4 were partial response. No recurrence, progression or distant metastasis occurred. There were 3 patients with grade I granulocytopenia, 3 grade I pneumonitis and 1 grade II pneumonitis. Conclusions: The cyberknife radiosurgery treatment in early stage lung cancer shows a high rate of local control and minimal toxicity. Long time follow-up is necessary to evaluate the survival data and late toxicity. (authors)

The theatrical stage as accident site in professional dance.

Science.gov (United States)

Wanke, Eileen M; Arendt, Michael; Mill, Helmgard; Koch, Franziska; Davenport, Jacqueline; Fischer, Axel; Groneberg, David A

2014-03-01

Reducing work-related health hazards at the different theatre workplaces is one aspect of preventive options in professional dance. This also applies to hazards on the highly variable theatrical stage areas. However, detailed information on these stages and their risks is not available. The aim of this study was to analyze and evaluate work-related traumatic injuries in the stage area. The basis for the evaluation was accident reports, from the German National Statutory Insurance, of work-related traumatic injuries occurring on stage in professional dancers (n=790: 407 males, 383 females) over a 17-year period (1995-2011). Most (79.4%) of the accidents on stage occurred during an ongoing performance (frequency: 10.1/100 performances), with only 19.7% occurring during rehearsals on stage (p<0.001). Due to the sustained injury, 30.2% of the dancers sustained a time-loss injury. Most (57.7%) of the injured dancers were older than 25 years. Of the accidents, 59.3% were initiated by a definably extrinsic cause, with 40.7% caused by intrinsic factors (p<0.001). Injuries were most commonly caused by the "partner" (21.7%) or "floor" (21.0%). The lower extremity was the most commonly affected body region (63.6%) (p<0.001). Stage performances seem to carry an increased injury risk compared to rehearsals. The "risk" of on-stage work is spread across various factors that seem to be stage-specific. There is a need for further qualitative and quantitative research to be able to classify the stage as workplace more precisely.

An automated image processing method for classification of diabetic retinopathy stages from conjunctival microvasculature images

Science.gov (United States)

Khansari, Maziyar M.; O'Neill, William; Penn, Richard; Blair, Norman P.; Chau, Felix; Shahidi, Mahnaz

2017-03-01

The conjunctiva is a densely vascularized tissue of the eye that provides an opportunity for imaging of human microcirculation. In the current study, automated fine structure analysis of conjunctival microvasculature images was performed to discriminate stages of diabetic retinopathy (DR). The study population consisted of one group of nondiabetic control subjects (NC) and 3 groups of diabetic subjects, with no clinical DR (NDR), non-proliferative DR (NPDR), or proliferative DR (PDR). Ordinary least square regression and Fisher linear discriminant analyses were performed to automatically discriminate images between group pairs of subjects. Human observers who were masked to the grouping of subjects performed image discrimination between group pairs. Over 80% and 70% of images of subjects with clinical and non-clinical DR were correctly discriminated by the automated method, respectively. The discrimination rates of the automated method were higher than human observers. The fine structure analysis of conjunctival microvasculature images provided discrimination of DR stages and can be potentially useful for DR screening and monitoring.

Cancerous Tumour Model Analysis and Constructing schemes of Anti-angiogenesis Therapy at an Early Stage

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O. Yu. Mukhomorova

2015-01-01

Full Text Available Anti-angiogenesis therapy is an alternative and successfully employed method for treatment of cancerous tumour. However, this therapy isn't widely used in medicine because of expensive drugs. It leads naturally to elaboration of such treatment regimens which use minimum amount of drugs.The aim of the paper is to investigate the model of development of illness and elaborate appropriate treatment regimens in the case of early diagnosis of the disease. The given model reflects the therapy at an intermediate stage of the disease treatment. Further treatment is aimed to destroy cancer cells and may be continued by other means, which are not reflected in the model.Analysis of the main properties of the model was carried out with consideration of two types of auxiliary systems. In the first case, the system is considered without control, as a model of tumour development in the absence of medical treatment. The study of the equilibrium point and determination of its type allowed us to describe disease dynamics and to determine tumour size resulting in death. In the second case a model with a constant control was investigated. The study of its equilibrium point showed that continuous control is not sufficient to support satisfactory patient's condition, and it is necessary to elaborate more complex treatment regimens. For this purpose, we used the method of terminal problems consisting in the search for such program control which forces system to a given final state. Selecting the initial and final states is due to medical grounds.As a result, we found two treatment regimens | one-stage treatment regimen and multi-stage one. The properties of each treatment regimen are analyzed and compared. The total amount of used drugs was a criterion for comparing these two treatment regimens. The theoretical conclusions obtained in this work are supported by computer modeling in MATLAB environment.

Stages of change and health‐related quality of life among employees of an institution

Science.gov (United States)

Liau, Siow Yen; Shafie, Asrul A; Ibrahim, Mohamed Izham Mohamed; Hassali, Mohamed Azmi; Othman, Ahmad Tajuddin; Mohamed, Mohamad Haniki Nik; Hamdi, Menal A

2011-01-01

Abstract Background  Transtheoretical Model of change has been used successfully in promoting behaviour change. Objective  To examine the relationships between health‐related quality of life (HRQoL) scores with the stages of change of adequate physical activity and fruit and vegetables intake. Design  This was a cross‐sectional study conducted among employees of the main campus and Engineering campus of Universiti Sains Malaysia (USM) during October 2009 and March 2010. Main variables studied: Data on physical activity and fruit and vegetable intake was collected using the WHO STEPS instrument for chronic disease risk factors surveillance. The Short Form‐12 health survey (SF‐12) was used to gather information on participants’ HRQoL. The current stages of change are measured using the measures developed by the Pro‐Change Behaviour Systems Incorporation. Statistical analysis: One way ANOVA and its non‐parametric equivalent Kruskal‐Wallis were used to compare the differences between SF‐12 scores with the stages of change. Results  A total of 144 employees were included in this analysis. A large proportion of the participants reported inadequate fruits and vegetable intake (92.3%) and physical activity (84.6%). Mean physical and mental component scores of SF‐12 were 50.39 (SD = 7.69) and 49.73 (SD = 8.64) respectively. Overall, there was no statistical significant difference in the SF‐12 domains scores with regards to the stages of change for both the risk factors. Conclusions  There were some evidence of positive relationship between stages of change of physical activity and fruit and vegetable intake with SF‐12 scores. Further studies need to be conducted to confirm this association. PMID:21645189

Immunity to viral haemorrhagic septicaemia (VHS) following DNA vaccination of rainbow trout at an early life-stage

DEFF Research Database (Denmark)

Lorenzen, Niels; Lorenzen, Ellen; Einer-Jensen, Katja

2001-01-01

-vaccination respectively, revealed that a highly protective and lasting immunity was established shortly after vaccination, in accordance with earlier experiments with larger fish. The defence mechanisms activated by the DNA vaccine are thus functional at an early life-stage in rainbow trout....

Three-dimensional visualisation of developmental stages of an apicomplexan fish blood parasite in its invertebrate host

Directory of Open Access Journals (Sweden)

Hayes Polly M

2011-11-01

Full Text Available Abstract Background Although widely used in medicine, the application of three-dimensional (3D imaging to parasitology appears limited to date. In this study, developmental stages of a marine fish haemogregarine, Haemogregarina curvata (Apicomplexa: Adeleorina, were investigated in their leech vector, Zeylanicobdella arugamensis; this involved 3D visualisation of brightfield and confocal microscopy images of histological sections through infected leech salivary gland cells. Findings 3D assessment demonstrated the morphology of the haemogregarine stages, their spatial layout, and their relationship with enlarged host cells showing reduced cellular content. Haemogregarine meronts, located marginally within leech salivary gland cells, had small tail-like connections to the host cell limiting membrane; this parasite-host cell interface was not visible in two-dimensional (2D light micrographs and no records of a similar connection in apicomplexan development have been traced. Conclusions This is likely the first account of the use of 3D visualisation to study developmental stages of an apicomplexan parasite in its invertebrate vector. Elucidation of the extent of development of the haemogregarine within the leech salivary cells, together with the unusual connections between meronts and the host cell membrane, illustrates the future potential of 3D visualisation in parasite-vector biology.

Smoking cessation: an application of theory of planned behavior to understanding progress through stages of change.

Science.gov (United States)

Bledsoe, Linda K

2006-07-01

The purpose of this research was to investigate variables relevant to smoking cessation early in the process of change through an application of the Theory of Planned Behavior [Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl and J. Beckman (Eds). Action-control: From cognition to behavior (pp.11-39). Heidelberg: Springer.] to the temporal structure provided by the Transtheoretical Model. Study 1 was a preliminary elicitation study (n=68) conducted to ground the concepts used in the model testing in Study 2 [Ajzen, I., Fishbein, M. (1980). Understanding attitudes and predicting social behavior, Englewood Cliffs, NJ: Prentice-Hall.]. Study 2 tested the proposed model fit with data from a sample of 230 adult smokers. Structural equation modeling did not support the Theory of Planned Behavior as a model of motivation for progress through the stages of change and highlighted measurement issues with perceived behavioral control. A modified model using the Theory of Reasoned Action provided a good fit to the data, accounting for approximately 64% of the variance in intention to quit smoking and stage of change. This research addresses the need for a more complete theoretical rationale for progress through stages of change.

Low axial drift stage and temperature controlled liquid cell for z-scan fluorescence correlation spectroscopy in an inverted confocal geometry

International Nuclear Information System (INIS)

Allgeyer, Edward S.; Sterling, Sarah M.; Neivandt, David J.; Mason, Michael D.

2011-01-01

A recent iteration of fluorescence correlation spectroscopy (FCS), z-scan FCS, has drawn attention for its elegant solution to the problem of quantitative sample positioning when investigating two-dimensional systems while simultaneously providing an excellent method for extracting calibration-free diffusion coefficients. Unfortunately, the measurement of planar systems using (FCS and) z-scan FCS still requires extremely mechanically stable sample positioning, relative to a microscope objective. As axial sample position serves as the inherent length calibration, instabilities in sample position will affect measured diffusion coefficients. Here, we detail the design and function of a highly stable and mechanically simple inverted microscope stage that includes a temperature controlled liquid cell. The stage and sample cell are ideally suited to planar membrane investigations, but generally amenable to any quantitative microscopy that requires low drift and excellent axial and lateral stability. In the present work we evaluate the performance of our custom stage system and compare it with the stock microscope stage and typical sample sealing and holding methods.

Advanced Low-Noise Research Fan Stage Design

Science.gov (United States)

Neubert, Robert; Bock, Larry; Malmborg, Eric; Owen-Peer, William

1997-01-01

This report describes the design of the Advanced Low-Noise Research Fan stage. The fan is a variable pitch design, which is designed at the cruise pitch condition. Relative to the cruise setting, the blade is closed at takeoff and opened for reverse thrust operation. The fan stage is a split flow design with fan exit guide vanes (FEGVs) and core stators. The fan stage design is combined with a nacelle and engine core duct to form a powered fan/nacelle subscale model. This model is intended for use in combined aerodynamic, acoustic, and structural testing in a wind tunnel. The fan has an outer diameter of 22 in. and a hub-to-tip of 0.426 in., which allows the use of existing NASA fan and cowl force balance and rig drive systems. The design parameters were selected to permit valid acoustic and aerodynamic comparisons with the Pratt & Whitney (P&W) 17- and 22-in. rigs previously tested under NASA contract. The fan stage design is described in detail. The results of the design axisymmetric and Navier-Stokes aerodynamic analysis are presented at the critical design conditions. The structural analysis of the fan rotor and attachment is included. The blade and attachment are predicted to have adequate low-cycle fatigue life and an acceptable operating range without resonant stress or flutter. The stage was acoustically designed with airfoil counts in the FEGV and core stator to minimize noise. A fan/FEGV tone analysis developed separately under NASA contract was used to determine the optimum airfoil counts. The fan stage was matched to the existing nacelle, designed under the previous P&W low-noise contract, to form a fan/nacelle model for wind tunnel testing. It is an axisymmetric nacelle for convenience in testing and analysis. Previous testing confirmed that the nacelle performed as required at various aircraft operating conditions.

[Value of transcutaneous staged dynamic oximetry of stage II arteritis of the leg].

Science.gov (United States)

Grard, C; Desmytterre, J; Vinckier, L; Hatron, P Y; Roux, J P; Warembourg, H; Devulder, B

1990-03-01

The clinical and prognostic value of transcutaneous oxygen pressure measurements at rest has been established in Leriche Stage III and IV occlusive peripheral arterial disease but is controversial in Stage II because there is an overlap of transcutaneous pO2 (Tc pO2) values with those of normal subjects. The authors report the results of Tc pO2 measurements during exercise testing in a group of patients with Stage II occlusive arterial disease of the lower limbs. Seventy-eight patients with an average age of 53 years (range 40 to 65 years) whose claudication perimeter and site of pain had been carefully assessed and who had also recently undergone Doppler arterial examination and arteriography and 35 control subjects with an average age of 54 years (range 45 to 70 years) were studied. The Tc pO2 was continuously measured with a multimodular Kontron Supermon at 4 different sites simultaneously: precordium (reference probe), thigh, calf and foot in the dorsal recumbent position after 30 minutes rest, during a standardised exercise stress test at 50 watts and during the recovery phase. The results were expressed as ratio of tissue oxygenation (RTO): thigh, calf or foot Tc pO2/precordial Tc pO2 X 100 in order to take into account the patients cardiorespiratory status and adaptation to exercise. The RTO in normal subjects remained at the upper limits of the resting value throughout exercise and then returned slowly to basal values during the recovery phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Capacitor blocks for linear transformer driver stages.

Science.gov (United States)

Kovalchuk, B M; Kharlov, A V; Kumpyak, E V; Smorudov, G V; Zherlitsyn, A A

2014-01-01

In the Linear Transformer Driver (LTD) technology, the low inductance energy storage components and switches are directly incorporated into the individual cavities (named stages) to generate a fast output voltage pulse, which is added along a vacuum coaxial line like in an inductive voltage adder. LTD stages with air insulation were recently developed, where air is used both as insulation in a primary side of the stages and as working gas in the LTD spark gap switches. A custom designed unit, referred to as a capacitor block, was developed for use as a main structural element of the transformer stages. The capacitor block incorporates two capacitors GA 35426 (40 nF, 100 kV) and multichannel multigap gas switch. Several modifications of the capacitor blocks were developed and tested on the life time and self breakdown probability. Blocks were tested both as separate units and in an assembly of capacitive module, consisting of five capacitor blocks. This paper presents detailed design of capacitor blocks, description of operation regimes, numerical simulation of electric field in the switches, and test results.

Nicotinic acetylcholine receptor density in cognitively intact subjects at an early stage of Parkinson’s disease

Directory of Open Access Journals (Sweden)

Ioannis Ugo eIsaias

2014-08-01

Full Text Available We investigated in vivo brain nicotinic acetylcholine receptor (nAChR distribution in cognitively intact subjects with Parkinson's disease (PD at an early stage of the disease. Fourteen patients and 13 healthy subjects were imaged with single photon emission computed tomography (SPECT and the radiotracer 5-[123I]iodo-3-[2(S-2-azetidinylmethoxy]pyridine ([123I]5IA. Patients were selected according to several criteria, including short duration of motor signs (<7 years and normal scores at an extensive neuropsychological evaluation. In PD patients, nAChR density was significantly higher in the putamen, the insular cortex and the supplementary motor area and lower in the caudate nucleus, the orbitofrontal cortex and the middle temporal gyrus. Disease duration positively correlated with nAChR density in the putamen ipsilateral (ρ=0.56, p<0.05 but not contralateral (ρ=0.49, p=0.07 to the clinically most affected hemibody.We observed, for the first time in vivo, higher nAChR density in brain regions of the motor and limbic basal ganglia circuits of subjects with PD. Our findings support the notion of an up-regulated cholinergic activity at the striatal and possibly cortical level in cognitively intact PD patients at an early stage of disease.

An unit cost adjusting heuristic algorithm for the integrated planning and scheduling of a two-stage supply chain

Directory of Open Access Journals (Sweden)

Jianhua Wang

2014-10-01

Full Text Available Purpose: The stable relationship of one-supplier-one-customer is replaced by a dynamic relationship of multi-supplier-multi-customer in current market gradually, and efficient scheduling techniques are important tools of the dynamic supply chain relationship establishing process. This paper studies the optimization of the integrated planning and scheduling problem of a two-stage supply chain with multiple manufacturers and multiple retailers to obtain a minimum supply chain operating cost, whose manufacturers have different production capacities, holding and producing cost rates, transportation costs to retailers.Design/methodology/approach: As a complex task allocation and scheduling problem, this paper sets up an INLP model for it and designs a Unit Cost Adjusting (UCA heuristic algorithm that adjust the suppliers’ supplying quantity according to their unit costs step by step to solve the model.Findings: Relying on the contrasting analysis between the UCA and the Lingo solvers for optimizing many numerical experiments, results show that the INLP model and the UCA algorithm can obtain its near optimal solution of the two-stage supply chain’s planning and scheduling problem within very short CPU time.Research limitations/implications: The proposed UCA heuristic can easily help managers to optimizing the two-stage supply chain scheduling problems which doesn’t include the delivery time and batch of orders. For two-stage supply chains are the most common form of actual commercial relationships, so to make some modification and study on the UCA heuristic should be able to optimize the integrated planning and scheduling problems of a supply chain with more reality constraints.Originality/value: This research proposes an innovative UCA heuristic for optimizing the integrated planning and scheduling problem of two-stage supply chains with the constraints of suppliers’ production capacity and the orders’ delivering time, and has a great

CT volumetry for gastric carcinoma: association with TNM stage

Energy Technology Data Exchange (ETDEWEB)

Hallinan, James T.P.D.; Peter, Luke; Makmur, Andrew [National University Health System (NUHS), Diagnostic Radiology, Singapore (Singapore); Venkatesh, Sudhakar K. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Yong, Wei Peng [NUHS, Hematology and Oncology, Singapore (Singapore); So, Jimmy B.Y. [NUHS, Surgery, Singapore (Singapore)

2014-12-15

We evaluated the feasibility of performing CT volumetry of gastric carcinoma (GC) and its correlation with TNM stage. This institutional review board-approved retrospective study was performed on 153 patients who underwent a staging CT study for histologically confirmed GC. CT volumetry was performed by drawing regions of interest including abnormal thickening of the stomach wall. Reproducibility of tumour volume (Tvol) between two readers was assessed. Correlation between Tvol and TNM/peritoneal staging derived from histology/surgical findings was evaluated using ROC analysis and compared with CT evaluation of TNM/peritoneal staging. Tvol was successfully performed in all patients. Reproducibility among readers was excellent (r = 0.97; P = 0.0001). The median Tvol of GC showed an incremental trend with T-stage (T1 = 27 ml; T2 = 32 ml; T3 = 53 ml and T4 = 121 ml, P < 0.01). Tvol predicted with good accuracy T-stage (≥T2:0.95; ≥T3:0.89 and T4:0.83, P = 0.0001), M-stage (0.87, P = 0.0001), peritoneal metastases (0.87, P = 0.0001) and final stage (≥stage 2:0.89; ≥stage 3:0.86 and stage 4:0.87, P = 0.0001), with moderate accuracy for N-stage (≥N1:0.75; ≥N2:0.74 and N3:0.75, P = 0.0001). Tvol was significantly (P < 0.05) more accurate than standard CT staging for prediction of T-stage, N3-stage, M-stage and peritoneal metastases. CT volumetry may provide useful adjunct information for preoperative staging of GC. (orig.)

CT volumetry for gastric carcinoma: association with TNM stage

International Nuclear Information System (INIS)

Hallinan, James T.P.D.; Peter, Luke; Makmur, Andrew; Venkatesh, Sudhakar K.; Yong, Wei Peng; So, Jimmy B.Y.

2014-01-01

We evaluated the feasibility of performing CT volumetry of gastric carcinoma (GC) and its correlation with TNM stage. This institutional review board-approved retrospective study was performed on 153 patients who underwent a staging CT study for histologically confirmed GC. CT volumetry was performed by drawing regions of interest including abnormal thickening of the stomach wall. Reproducibility of tumour volume (Tvol) between two readers was assessed. Correlation between Tvol and TNM/peritoneal staging derived from histology/surgical findings was evaluated using ROC analysis and compared with CT evaluation of TNM/peritoneal staging. Tvol was successfully performed in all patients. Reproducibility among readers was excellent (r = 0.97; P = 0.0001). The median Tvol of GC showed an incremental trend with T-stage (T1 = 27 ml; T2 = 32 ml; T3 = 53 ml and T4 = 121 ml, P < 0.01). Tvol predicted with good accuracy T-stage (≥T2:0.95; ≥T3:0.89 and T4:0.83, P = 0.0001), M-stage (0.87, P = 0.0001), peritoneal metastases (0.87, P = 0.0001) and final stage (≥stage 2:0.89; ≥stage 3:0.86 and stage 4:0.87, P = 0.0001), with moderate accuracy for N-stage (≥N1:0.75; ≥N2:0.74 and N3:0.75, P = 0.0001). Tvol was significantly (P < 0.05) more accurate than standard CT staging for prediction of T-stage, N3-stage, M-stage and peritoneal metastases. CT volumetry may provide useful adjunct information for preoperative staging of GC. (orig.)

CT staging of renal pelvis tumor

International Nuclear Information System (INIS)

Yoon, Soo Woong; Cho, Kyoung Sik; Lee, Jong Hwa; Ham, Su Yeon; Won, Yeong Cheol; Ji, Eun Kyung; Choi, Seong Hun; Shin, Byung Suck

1999-01-01

To assess the value of computed tomography (CT) in the preoperative staging of transitional cell carcinoma (TCC) of the renal pelvis. We retrospectively evaluated the CT TNM staging of 38 patients with TCC of the renal pelvis who had undergone preoperative abdominal CT examination between January 1990 and January 1998. In CT staging for differentiation between early-stage (T0-2) and advanced-stage disease (T3-T4), three criteria were used, namely the presence or obliteration of the renal sinus fat layer, the smoothness or irregularity of margin between the tumor and renal parenchyma, and the presence or absence of hydronephrosis proximal to the tumor. CT staging was performed by two genitourinary radiologists blinded to the pathologic results, and was compared with pathologic staging. Pathologic results revealed 19 cases of early stage disease (T0=8, T1=9, T2=2) and 19 of advanced stage (T3=12, T4=7). Overall CT staging accuracy was 82%(31/38) ; four cases were overstaged and three were understaged. In early-stage disease, sensitivity and specificity were 79%, and 84%, and in advanced stage disease were 83% and 80%. Three of four overstaged cases showed hydronephrosis proximal to the tumor. In the second CT staging, using proximal hydronephrosis of the tumor as a criterion for early-stage disease, the sensitivity and specificity of early-stage disease were 95% and 75%, respectively, and the specificity of advanced-stage disease was 95%. When hydronephrosis proximal to a tumor was considered to be a sign of early stage disease, the CT staging of renal pelvic TCC was highly accurate

An inexact mixed risk-aversion two-stage stochastic programming model for water resources management under uncertainty.

Science.gov (United States)

Li, W; Wang, B; Xie, Y L; Huang, G H; Liu, L

2015-02-01

Uncertainties exist in the water resources system, while traditional two-stage stochastic programming is risk-neutral and compares the random variables (e.g., total benefit) to identify the best decisions. To deal with the risk issues, a risk-aversion inexact two-stage stochastic programming model is developed for water resources management under uncertainty. The model was a hybrid methodology of interval-parameter programming, conditional value-at-risk measure, and a general two-stage stochastic programming framework. The method extends on the traditional two-stage stochastic programming method by enabling uncertainties presented as probability density functions and discrete intervals to be effectively incorporated within the optimization framework. It could not only provide information on the benefits of the allocation plan to the decision makers but also measure the extreme expected loss on the second-stage penalty cost. The developed model was applied to a hypothetical case of water resources management. Results showed that that could help managers generate feasible and balanced risk-aversion allocation plans, and analyze the trade-offs between system stability and economy.

Is ADHD an early stage in the development of borderline personality disorder?

DEFF Research Database (Denmark)

Storebø, Ole Jakob; Simonsen, Erik

2014-01-01

BACKGROUND: Several studies report associations between adults with borderline personality disorder (BPD) and a history of attention-deficit hyperactivity (ADHD) symptoms in childhood. AIMS: To explore the association between BPD and a history of ADHD in childhood. METHOD: A comprehensive search......: Most of the 15 articles showed a statistical association between ADHD and BPD. The data, most strongly provided a basis for the hypotheses that ADHD is either an early developmental stage of BPD, or that the two disorders share an environmental and genetic aetiology. Furthermore, one of the disorders...... seems to give a synergic effect, reinforce the other or complicate the disorders. In one prospective study, the risk factor for children with ADHD to develop BPD was as high as odds ratio 13.16. No studies have looked at treatment of ADHD as a mediator of the risk for BPD. CONCLUSIONS: Many studies...

Wide-bandwidth bilateral control using two-stage actuator system

International Nuclear Information System (INIS)

Kokuryu, Saori; Izutsu, Masaki; Kamamichi, Norihiro; Ishikawa, Jun

2015-01-01

This paper proposes a two-stage actuator system that consists of a coarse actuator driven by a ball screw with an AC motor (the first stage) and a fine actuator driven by a voice coil motor (the second stage). The proposed two-stage actuator system is applied to make a wide-bandwidth bilateral control system without needing expensive high-performance actuators. In the proposed system, the first stage has a wide moving range with a narrow control bandwidth, and the second stage has a narrow moving range with a wide control bandwidth. By consolidating these two inexpensive actuators with different control bandwidths in a complementary manner, a wide bandwidth bilateral control system can be constructed based on a mechanical impedance control. To show the validity of the proposed method, a prototype of the two-stage actuator system has been developed and basic performance was evaluated by experiment. The experimental results showed that a light mechanical impedance with a mass of 10 g and a damping coefficient of 2.5 N/(m/s) that is an important factor to establish good transparency in bilateral control has been successfully achieved and also showed that a better force and position responses between a master and slave is achieved by using the proposed two-stage actuator system compared with a narrow bandwidth case using a single ball screw system. (author)

Updated guidelines on the preoperative staging of thyroid cancer

Energy Technology Data Exchange (ETDEWEB)

Kim, Hye Jung [Dept. of Radiology, Kyungpook National University Medical Center, Daegu (Korea, Republic of)

2017-10-15

Recent studies have provided prognostic information and recommendations for staging thyroid cancers that have changed the staging and management guidelines for the disease. Consequently, minimal extrathyroidal extension (ETE) was removed from the T3 stage classification in the eighth edition of the TNM staging system by the American Joint Committee on Cancer. New T categories have been subsequently added, including T3a, defined as a tumor >4 cm in its greatest dimension, limited to the thyroid gland, and T3b, defined as a tumor of any size with gross ETE invading only the strap muscles. In this article, the author reviews the changes in the TNM staging system for thyroid cancer, with an emphasis on ultrasonography in preoperative staging.

An adaptive three-stage extended Kalman filter for nonlinear discrete-time system in presence of unknown inputs.

Science.gov (United States)

Xiao, Mengli; Zhang, Yongbo; Wang, Zhihua; Fu, Huimin

2018-04-01

Considering the performances of conventional Kalman filter may seriously degrade when it suffers stochastic faults and unknown input, which is very common in engineering problems, a new type of adaptive three-stage extended Kalman filter (AThSEKF) is proposed to solve state and fault estimation in nonlinear discrete-time system under these conditions. The three-stage UV transformation and adaptive forgetting factor are introduced for derivation, and by comparing with the adaptive augmented state extended Kalman filter, it is proven to be uniformly asymptotically stable. Furthermore, the adaptive three-stage extended Kalman filter is applied to a two-dimensional radar tracking scenario to illustrate the effect, and the performance is compared with that of conventional three stage extended Kalman filter (ThSEKF) and the adaptive two-stage extended Kalman filter (ATEKF). The results show that the adaptive three-stage extended Kalman filter is more effective than these two filters when facing the nonlinear discrete-time systems with information of unknown inputs not perfectly known. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

Proteomic analysis of young leaves at three developmental stages in an albino tea cultivar

Directory of Open Access Journals (Sweden)

Li Juan

2011-08-01

Full Text Available Abstract Background White leaf No.1 is a typical albino tea cultivar grown in China and it has received increased attention in recent years due to the fact that white leaves containing a high level of amino acids, which are very important components affecting the quality of tea drink. According to the color of its leaves, the development of this tea cultivar is divided into three stages: the pre-albinistic stage, the albinistic stage and the regreening stage. To understand the intricate mechanism of periodic albinism, a comparative proteomic approach based on two-dimensional electrophoresis (2-DE and mass spectrometry was adopted first time to identify proteins that changed in abundance during the three developmental periods. Results The 2-DE results showed that the expression level of 61 protein spots varied markedly during the three developmental stages. To analyze the functions of the significantly differentially expressed protein spots, 30 spots were excised from gels and analyzed by matrix-assisted laser desorption ionization-time of flight-tandem mass spectrometry. Of these, 26 spots were successfully identified. All identified protein spots were involved in metabolism of carbon, nitrogen and sulfur, photosynthesis, protein processing, stress defense and RNA processing, indicating these physiological processes may play crucial roles in the periodic albinism. Quantitative real-time RT-PCR analysis was used to assess the transcriptional level of differentially expressed proteins. In addition, the ultrastructural studies revealed that the etioplast-chloroplast transition in the leaf cell of White leaf No. 1 was inhibited and the grana in the chloroplast was destroyed at the albinistic stage. Conclusions In this work, the proteomic analysis revealed that some proteins may have important roles in the molecular events involved in periodic albinism of White leaf No. 1 and identificated many attractive candidates for further investigation. In

Measuring motivation using the transtheoretical (stages of change) model: A follow-up study of people who failed an online hearing screening.

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Ingo, Elisabeth; Brännström, K Jonas; Andersson, Gerhard; Lunner, Thomas; Laplante-Lévesque, Ariane

2016-07-01

Acceptance and readiness to seek professional help have shown to be important factors for favourable audiological rehabilitation outcomes. Theories from health psychology such as the transtheoretical (stages-of-change) model could help understand behavioural change in people with hearing impairment. In recent studies, the University of Rhode Island change assessment (URICA) has been found to have good predictive validity. In a previous study, 224 Swedish adults who had failed an online hearing screening completed URICA and two other measures of stages of change. This follow-up aimed to: (1) determine prevalence of help-seeking at a hearing clinic and hearing aid uptake, and (2) explore the predictive validity of the stages of change measures by a follow-up on the 224 participants who had failed a hearing screening 18 months previously. A total of 122 people (54%) completed the follow-up online questionnaire, including the three measures and questions regarding experience with hearing help-seeking and hearing aid uptake. Since failing the online hearing screening, 61% of participants had sought help. A good predictive validity for a one-item measure of stages of change was reported. The Staging algorithm was the stages of change measure with the best ability to predict help-seeking 18 months later.

One-stage exchange with antibacterial hydrogel coated implants provides similar results to two-stage revision, without the coating, for the treatment of peri-prosthetic infection.

Science.gov (United States)

Capuano, Nicola; Logoluso, Nicola; Gallazzi, Enrico; Drago, Lorenzo; Romanò, Carlo Luca

2018-03-16

Aim of this study was to verify the hypothesis that a one-stage exchange procedure, performed with an antibiotic-loaded, fast-resorbable hydrogel coating, provides similar infection recurrence rate than a two-stage procedure without the coating, in patients affected by peri-prosthetic joint infection (PJI). In this two-center case-control, study, 22 patients, treated with a one-stage procedure, using implants coated with an antibiotic-loaded hydrogel [defensive antibacterial coating (DAC)], were compared with 22 retrospective matched controls, treated with a two-stage revision procedure, without the coating. At a mean follow-up of 29.3 ± 5.0 months, two patients (9.1%) in the DAC group showed an infection recurrence, compared to three patients (13.6%) in the two-stage group. Clinical scores were similar between groups, while average hospital stay and antibiotic treatment duration were significantly reduced after one-stage, compared to two-stage (18.9 ± 2.9 versus 35.8 ± 3.4 and 23.5 ± 3.3 versus 53.7 ± 5.6 days, respectively). Although in a relatively limited series of patients, our data shows similar infection recurrence rate after one-stage exchange with DAC-coated implants, compared to two-stage revision without coating, with reduced overall hospitalization time and antibiotic treatment duration. These findings warrant further studies in the possible applications of antibacterial coating technologies to treat implant-related infections. III.

Staging structures of the intercalation compounds Ag/sub x/TiS2

International Nuclear Information System (INIS)

Bardhan, K.K.; Kirczenow, G.; Jackle, G.; Irwin, J.C.

1986-01-01

An extensive investigation of the structure, and in particular the staging, of powdered samples of the intercalation compounds Ag/sub x/TiS 2 (0 0 C. The (T,x) phase diagram contains three phases: a high-x (dense) stage-1 phase, a stage-disordered phase, which at low x or high temperatures appears to become a pure low-x (dilute) stage-1 phase, and a simple stage-2 phase. On the high-x side of its stability region the stage-2 phase undergoes an apparent first-order transition to the dense stage-1 phase, but on the high-temperature side it proceeds continuously, through stage-disordered states, to a dilute stage-1 phase. On the low-x side of the stage-2 region there is also a dilute stage-1 phase. At sufficiently high temperatures a novel coexistence of the two stage-1 phases is observed. This is the first time that the high-temperature stability limit of the stage-2 region has been probed in any intercalation compound. The results are compared with recent theoretical models

Changes of endocrine and ultrasound markers as ovarian aging in modifying the Stages of Reproductive Aging Workshop (STRAW) staging system with subclassification of mid reproductive age stage.

Science.gov (United States)

Ding, Ting; Luo, Aiyue; Jiang, Jingjing; Du, Xiaofang; Yang, Shuhong; Lai, Zhiwen; Shen, Wei; Lu, Yunping; Ma, Ding; Wang, Shixuan

2013-01-01

To demonstrate the changes of ovarian aging markers across the Stages of Reproductive Aging Workshop (STRAW) stages and modify it with subclassification of mid reproductive age stage (MR). Healthy females were classified according to the STRAW system. Serum basal FSH, LH, E2, and anti-Müllerian hormone (AMH) were detected, FSH/LH ratio calculated, and antral follicle counts (AFCs) determined in follicular phase. Progression through the whole STRAW stages under MR stage subdivided is associated with elevations in FSH, LH, FSH/LH ratio and decreases in E2, AMH and AFCs (p age in MR stage. 0.982 ng/ml AMH and 3 antral follicles (low level of MR 25-30 years) were set as cutoffs to distinguish MR stage into early mid reproductive age (EMR) and late mid reproductive age (LMR) stages. The women in EMR stage compared with LMR could retrieve more oocytes in IVF treatment (p stage, demonstrating disparate reproductive aging period with reduced ovarian reserve in young age across the STRAW stages.

Images of gastric cancer stages

International Nuclear Information System (INIS)

Castro Aragon, I.M.

1999-01-01

The present work has the objective to review the importance of the images in the preoperating stage of the gastric cancer. It has been emphasized in the modalities of transabdominal ultrasound as much as endoscopic and TAC since they are most valuable in the stage. Certainly the importance of conventional radiology (gastroduodenal series) is also valuable in the stage of the tumor, specially in considering the depth of the same one. In order to make this overhaul, the recent bibliography was consulted but, specially the published one by Japaneses since they follow a classification and methodology different from the used one in most of the countries that belong to the World-wide Organization of the Health. They made an overhaul of approximately 200 cases of patients who have been diagnosed and treated in the Center of Detection of Gastric Cancer of Cartago. In each case review the file, radiological, sonographic and pathological studies, and the cases were chosen that better illustrated the exposed subjects. (Author) [es

Orthognathic Surgery and Rhinoplasty: Simultaneous or Staged?

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Sun, Alexander H; Steinbacher, Derek M

2018-02-01

Orthognathic surgery can significantly impact the nasolabial envelope, and at times requires an adjunctive rhinoplasty. The purpose of this study was to evaluate nasal morphology in orthognathic patients, focusing on predictive variables, and the need for and timing of definitive rhinoplasty. Based on these data, an algorithm for the implementation of adjunctive rhinoplasty is proposed. A review of cases over a 3-year period was completed. Information regarding demographic, diagnostic, and operative details; nasal morphology; and use of rhinoplasty was compiled. Three-dimensional images were used to quantify anatomical variables. Over 589 patients were reviewed during this period. Of these, 163 fulfilled inclusion criteria for this study. The mean age was 23.3 years. In total, 41.7 percent of orthognathic cases underwent adjunctive rhinoplasty. Of these, 82.4 percent were staged and 17.6 percent were simultaneous. The average time between staged procedures was 208 days. When simultaneous, 16.7 percent of the orthognathic procedures had significant maxillary movement (advancement >4 to 5 mm, impaction >2 mm, alar base excisions); in comparison, 92.9 percent of staged cases had significant maxillary movement (p orthognathic surgery. The authors present an algorithm to extensively treat the nasomaxillofacial relationship using orthognathic surgery alone, orthognathic surgery in concert with rhinoplasty, or orthognathic surgery followed by staged rhinoplasty.

Computerized tomography for diagnosis and staging of renal pelvic tumor

International Nuclear Information System (INIS)

Fukuoka, Hiroshi; Goto, Akihiko; Kitamura, Hajime

1985-01-01

Although we have no definite criteria available yet for clinical staging of renal pelvic tumor, the preoperative staging of this disease is nevertheless important in view of the current tendency that the necessity for renal conservative operation is considered. CT is now a routine work also for diagnosing renal pelvic tumor. The present study was performed in order to validate its usefulness for diagnosing and staging the disease. Our series consisted of 8 patients with renal pelvic tumor, in 6 of whom a definite diagnosis was established after demonstrating filling defect on pyelogram, but in the remaining two with extensive infiltration, and squamous cell carcinoma associated with staghorn calculus respectively, CT failed to provide a definite diagnosis. CT findings of an extension of the mass in the renal pelvis or renal calyces into adipose tissue of the renal sinus or renal parenchyma were judged to indicate an invasive type (Stage III), while a non-invasive type (Stage I or II) was defined on the basis of otherwise CT findings. Consistency with pathological stages was noted in 7 of the 8 cases (87.5 %). It was difficult to differentiate Stage I and Stage II on CT findings. CT was considered to be extremely useful tool for preoperative staging of renal pelvic tumor. (author)

Functional assessment of the cervical spine in F-16 pilots with and without neck pain

NARCIS (Netherlands)

de Loose, Veerle; van den Oord, Mariek; Burnotte, Frédéric; van Tiggelen, Damien; Stevens, Veerle; Cagnie, Barbara; Danneels, Lieven; Witvrouw, Erik

2009-01-01

INTRODUCTION: Spinal symptoms in fighter pilots are a serious aeromedical problem. The most common neck complaints are muscular pain and strain. The aim of the current study was to determine possible differences in the cervical range of motion (CROM), neck position sense, and neck muscle strength

Neutrino masses in an SO(10) model with an intermediate stage of symmetry breaking

International Nuclear Information System (INIS)

Svetovoi, V.B.

1982-01-01

The effect on neutrino masses of an intermediate stage in symmetry breaking different from SU(5) is investigated in detail for the SO(10) model. There are two possibilities depending on the contents of the Higgs sector: i) m/sub ν/approx.m/sub f/(M/sub W//M 1 ); ii) m/sub ν/approx.m/sub f/(M/sub W//M 1 )(M/M 1 ), where M, M 1 and M/sub W/ are the scales of the breaking of the original SO(10) symmetry, the intermediate symmetry, and the standard SU/sub c/(3) x SU/sub L/(2) x U(1) symmetry, respectively, and m/sub f/ is a typical fermion mass. It is shown that a Majorana mass of the right-handed-neutrino (ν/sub R/) of a purely loop origin would result in too large a mass of the usual neutrinos, so a tree-graph contribution to the mass of ν/sub R/ is necessary. Numerical estimates for the neutrino masses are discussed

Five-Axis Goniometric Stage

Science.gov (United States)

2011-02-01

are required, as in a thread type used for mechanical motion. Caster – is an un-driven wheel that is designed to be mounted to the bottom of a larger...89 Figure 96: XY Acme Shaft Modification ...20® frame and an anodized sheet metal plate. The entire stage is firmly attached to the base with 80/20® cross supports. Four casters support the

Multi-stage decoding for multi-level block modulation codes

Science.gov (United States)

Lin, Shu

1991-01-01

In this paper, we investigate various types of multi-stage decoding for multi-level block modulation codes, in which the decoding of a component code at each stage can be either soft-decision or hard-decision, maximum likelihood or bounded-distance. Error performance of codes is analyzed for a memoryless additive channel based on various types of multi-stage decoding, and upper bounds on the probability of an incorrect decoding are derived. Based on our study and computation results, we find that, if component codes of a multi-level modulation code and types of decoding at various stages are chosen properly, high spectral efficiency and large coding gain can be achieved with reduced decoding complexity. In particular, we find that the difference in performance between the suboptimum multi-stage soft-decision maximum likelihood decoding of a modulation code and the single-stage optimum decoding of the overall code is very small: only a fraction of dB loss in SNR at the probability of an incorrect decoding for a block of 10(exp -6). Multi-stage decoding of multi-level modulation codes really offers a way to achieve the best of three worlds, bandwidth efficiency, coding gain, and decoding complexity.

Stages of Biological Development across Age: An Analysis of Canadian Health Measure Survey 2007-2011.

Science.gov (United States)

Chao, Yi-Sheng; Wu, Hsing-Chien; Wu, Chao-Jung; Chen, Wei-Chih

2017-01-01

The stages of biological development are not clearly defined despite the fact that they have been used to refer to concepts such as adolescence and aging. This study aimed to (1) propose and test a framework to search for stages of representative components and determine stages of stability and transition, (2) identify stages of biological development based on health questionnaire and biomarker data, and (3) interpret the major trajectories in a health and biomarker database. This study analyzed the data on the Canadian Health Measures Survey (CHMS) interviewees from cycle 1 to 3 (2007-2013) in Canada. We selected 282 variables containing information from questionnaire and on biomarkers after removing redundant variables based on high correlation. Fifty-nine nominal variables were replaced by 122 binominal variables, leaving 345 variables for analysis. Principal component (PC) analysis was conducted to summarize the data and the loadings were used to interpret the PCs. A stable stage was assumed to be the age groups without significantly different values of PCs. The CHMS interviewed 16,340 Canadians. Of all, 51.25% were female. The age ranged from 6 to 79 years (mean = 34.41 years, 95% CI = 34.74-34.08). The proportions of total variance explained by the first three PCs were 12.14, 4.03, and 3.19%, respectively. The differences of the first PC were not significant, especially between age 22 and 33, 34 and 40, 41 and 45, 46 and 71, and 72 and 79 years (adjusted p  > 0.05 for all). The leading variable, in terms of the variance contributed to PC1, was time spent in physical activities, followed by variables related to alcohol consumption, and smoking. The 13 leading contributors to PC2 variances were all lung function measures. There are stages of stability and transition across all age groups based on the first PCs. The first and second PCs are related to physical development and lung function. The identification of stable stages is the first step

Stages of Change or Changes of Stage? Predicting Transitions in Transtheoretical Model Stages in Relation to Healthy Food Choice

Science.gov (United States)

Armitage, Christopher J.; Sheeran, Paschal; Conner, Mark; Arden, Madelynne A.

2004-01-01

Relatively little research has examined factors that account for transitions between transtheoretical model (TTM) stages of change. The present study (N=787) used sociodemographic, TTM, and theory of planned behavior (TPB) variables, as well as theory-driven interventions to predict changes in stage. Longitudinal analyses revealed that…

An early burst of IFN-γ induced by the pre-erythrocytic stage favours Plasmodium yoelii parasitaemia in B6 mice

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Barbier Eliane

2009-06-01

Full Text Available Abstract Background In murine models of malaria, an early proinflammatory response has been associated with the resolution of blood-stage infection. To dissect the protective immune mechanims that allow the control of parasitaemia, the early immune response of C57BL/6 mice induced during a non-lethal plasmodial infection was analysed. Methods Mice were infected with Plasmodium yoelii 265BY sporozoites, the natural invasive form of the parasite, in order to complete its full life cycle. The concentrations of three proinflammatory cytokines in the sera of mice were determined by ELISA at different time points of infection. The contribution of the liver and the spleen to this cytokinic response was evaluated and the cytokine-producing lymphocytes were identified by flow cytometry. The physiological relevance of these results was tested by monitoring parasitaemia in genetically deficient C57BL/6 mice or wild-type mice treated with anti-cytokine neutralizing antibody. Finally, the cytokinic response in sera of mice infected with parasitized-RBCs was analysed. Results The early immune response of C57BL/6 mice to sporozoite-induced malaria is characterized by a peak of IFN-γ in the serum at day 5 of infection and splenic CD4 T lymphocytes are the major producer of this cytokine at this time point. Somewhat unexpected, the parasitaemia is significantly lower in P. yoelii-infected mice in the absence of IFN-γ. More precisely, at early time points of infection, IFN-γ favours parasitaemia, whereas helping to clear efficiently the blood-stage parasites at later time points. Interestingly, the early IFN-γ burst is induced by the pre-erythrocytic stage. Conclusion These results challenge the current view regarding the role of IFN-γ on the control of parasite growth since they show that IFN-γ is not an essential mediator of protection in P. yoelii-infected C57BL/6 mice. Moreover, the mice parasitaemia is more efficiently controlled in the absence of an

Interconnected levels of Multi-Stage Marketing – A Triadic approach

DEFF Research Database (Denmark)

Vedel, Mette; Geersbro, Jens; Ritter, Thomas

2012-01-01

must not only decide in general on the merits of multi-stage marketing for their firm, but must also decide on which level they will engage in multi-stage marketing. The triadic perspective enables a rich and multi-dimensional understanding of how different business relationships influence each other......Multi-stage marketing gains increasing attention as knowledge of and influence on the customer's customer become more critical for the firm's success. Despite this increasing managerial relevance, systematic approaches for analyzing multi-stage marketing are still missing. This paper conceptualizes...... different levels of multi-stage marketing and illustrates these stages with a case study. In addition, a triadic perspective is introduced as an analytical tool for multi-stage marketing research. The results from the case study indicate that multi-stage marketing exists on different levels. Thus, managers...

White blood cell differential count of maturation stages in bone marrow smear using dual-stage convolutional neural networks.

Directory of Open Access Journals (Sweden)

Jin Woo Choi

Full Text Available The white blood cell differential count of the bone marrow provides information concerning the distribution of immature and mature cells within maturation stages. The results of such examinations are important for the diagnosis of various diseases and for follow-up care after chemotherapy. However, manual, labor-intensive methods to determine the differential count lead to inter- and intra-variations among the results obtained by hematologists. Therefore, an automated system to conduct the white blood cell differential count is highly desirable, but several difficulties hinder progress. There are variations in the white blood cells of each maturation stage, small inter-class differences within each stage, and variations in images because of the different acquisition and staining processes. Moreover, a large number of classes need to be classified for bone marrow smear analysis, and the high density of touching cells in bone marrow smears renders difficult the segmentation of single cells, which is crucial to traditional image processing and machine learning. Few studies have attempted to discriminate bone marrow cells, and even these have either discriminated only a few classes or yielded insufficient performance. In this study, we propose an automated white blood cell differential counting system from bone marrow smear images using a dual-stage convolutional neural network (CNN. A total of 2,174 patch images were collected for training and testing. The dual-stage CNN classified images into 10 classes of the myeloid and erythroid maturation series, and achieved an accuracy of 97.06%, a precision of 97.13%, a recall of 97.06%, and an F-1 score of 97.1%. The proposed method not only showed high classification performance, but also successfully classified raw images without single cell segmentation and manual feature extraction by implementing CNN. Moreover, it demonstrated rotation and location invariance. These results highlight the promise of

White blood cell differential count of maturation stages in bone marrow smear using dual-stage convolutional neural networks.

Science.gov (United States)

Choi, Jin Woo; Ku, Yunseo; Yoo, Byeong Wook; Kim, Jung-Ah; Lee, Dong Soon; Chai, Young Jun; Kong, Hyoun-Joong; Kim, Hee Chan

2017-01-01

The white blood cell differential count of the bone marrow provides information concerning the distribution of immature and mature cells within maturation stages. The results of such examinations are important for the diagnosis of various diseases and for follow-up care after chemotherapy. However, manual, labor-intensive methods to determine the differential count lead to inter- and intra-variations among the results obtained by hematologists. Therefore, an automated system to conduct the white blood cell differential count is highly desirable, but several difficulties hinder progress. There are variations in the white blood cells of each maturation stage, small inter-class differences within each stage, and variations in images because of the different acquisition and staining processes. Moreover, a large number of classes need to be classified for bone marrow smear analysis, and the high density of touching cells in bone marrow smears renders difficult the segmentation of single cells, which is crucial to traditional image processing and machine learning. Few studies have attempted to discriminate bone marrow cells, and even these have either discriminated only a few classes or yielded insufficient performance. In this study, we propose an automated white blood cell differential counting system from bone marrow smear images using a dual-stage convolutional neural network (CNN). A total of 2,174 patch images were collected for training and testing. The dual-stage CNN classified images into 10 classes of the myeloid and erythroid maturation series, and achieved an accuracy of 97.06%, a precision of 97.13%, a recall of 97.06%, and an F-1 score of 97.1%. The proposed method not only showed high classification performance, but also successfully classified raw images without single cell segmentation and manual feature extraction by implementing CNN. Moreover, it demonstrated rotation and location invariance. These results highlight the promise of the proposed method

White blood cell differential count of maturation stages in bone marrow smear using dual-stage convolutional neural networks

Science.gov (United States)

Choi, Jin Woo; Ku, Yunseo; Yoo, Byeong Wook; Kim, Jung-Ah; Lee, Dong Soon; Chai, Young Jun; Kong, Hyoun-Joong

2017-01-01

The white blood cell differential count of the bone marrow provides information concerning the distribution of immature and mature cells within maturation stages. The results of such examinations are important for the diagnosis of various diseases and for follow-up care after chemotherapy. However, manual, labor-intensive methods to determine the differential count lead to inter- and intra-variations among the results obtained by hematologists. Therefore, an automated system to conduct the white blood cell differential count is highly desirable, but several difficulties hinder progress. There are variations in the white blood cells of each maturation stage, small inter-class differences within each stage, and variations in images because of the different acquisition and staining processes. Moreover, a large number of classes need to be classified for bone marrow smear analysis, and the high density of touching cells in bone marrow smears renders difficult the segmentation of single cells, which is crucial to traditional image processing and machine learning. Few studies have attempted to discriminate bone marrow cells, and even these have either discriminated only a few classes or yielded insufficient performance. In this study, we propose an automated white blood cell differential counting system from bone marrow smear images using a dual-stage convolutional neural network (CNN). A total of 2,174 patch images were collected for training and testing. The dual-stage CNN classified images into 10 classes of the myeloid and erythroid maturation series, and achieved an accuracy of 97.06%, a precision of 97.13%, a recall of 97.06%, and an F-1 score of 97.1%. The proposed method not only showed high classification performance, but also successfully classified raw images without single cell segmentation and manual feature extraction by implementing CNN. Moreover, it demonstrated rotation and location invariance. These results highlight the promise of the proposed method

A new computerized moving stage for optical microscopes

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Hatiboglu, Can Ulas; Akin, Serhat

2004-06-01

Measurements of microscope stage movements in the x and y directions are of importance for some stereological methods. Traditionally, the length of stage movements is measured with differing precision and accuracy using a suitable motorized stage, a microscope and software. Such equipment is generally expensive and not readily available in many laboratories. One other challenging problem is the adaptability to available microscope systems which weakens the possibility of the equipment to be used with any kind of light microscope. This paper describes a simple and cheap programmable moving stage that can be used with the available microscopes in the market. The movements of the stage are controlled by two servo-motors and a controller chip via a Java-based image processing software. With the developed motorized stage and a microscope equipped with a CCD camera, the software allows complete coverage of the specimens with minimum overlap, eliminating the optical strain associated with counting hundreds of images through an eyepiece, in a quick and precise fashion. The uses and the accuracy of the developed stage are demonstrated using thin sections obtained from a limestone core plug.

Low Noise Research Fan Stage Design

Science.gov (United States)

Hobbs, David E.; Neubert, Robert J.; Malmborg, Eric W.; Philbrick, Daniel H.; Spear, David A.

1995-01-01

This report describes the design of a Low Noise ADP Research Fan stage. The fan is a variable pitch design which is designed at the cruise pitch condition. Relative to the cruise setting, the blade is closed at takeoff and opened for reverse thrust operation. The fan stage is a split flow design with fan exit guide vanes and core stators. This fan stage design was combined with a nacelle and engine core duct to form a powered fan/nacelle, subscale model. This model is intended for use in aerodynamic performance, acoustic and structural testing in a wind tunnel. The model has a 22-inch outer fan diameter and a hub-to-top ratio of 0.426 which permits the use of existing NASA fan and cowl force balance designs and rig drive system. The design parameters were selected to permit valid acoustic and aerodynamic comparisons with the PW 17-inch rig previously tested under NASA contract. The fan stage design is described in detail. The results of the design axisymmetric analysis at aerodynamic design condition are included. The structural analysis of the fan rotor and attachment is described including the material selections and stress analysis. The blade and attachment are predicted to have adequate low cycle fatigue life, and an acceptable operating range without resonant stress or flutter. The stage was acoustically designed with airfoil counts in the fan exit guide vane and core stator to minimize noise. A fan-FEGV tone analysis developed separately under NASA contract was used to determine these airfoil counts. The fan stage design was matched to a nacelle design to form a fan/nacelle model for wind tunnel testing. The nacelle design was developed under a separate NASA contract. The nacelle was designed with an axisymmetric inlet, cowl and nozzle for convenience in testing and fabrication. Aerodynamic analysis of the nacelle confirmed the required performance at various aircraft operating conditions.

Assessment of Growth Using Mandibular Canine Calcification Stages and Its Correlation with Modified MP3 Stages.

Science.gov (United States)

Nayak, Reshma; Nayak, Us Krishna; Hegde, Gautam

2010-01-01

Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. A total of 160 periapical radiographs (80 males and 80 females), of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian's stages of dental calcification and the modified MP3 stages. The correlation between the developmental stages of MP3 and the mandibular right canine in male and female groups, is of high statistical significance (p = 0.001). The correlation coefficient between MP3 stages and developmental stages of mandibular canine and chronological age in male and females was found to be not significant. The correlation between the mandibular canine calcification stages and MP3 stages was found to be significant. The developmental stages of the mandibular canine could be used very reliably as a sole indicator for assessment of skeletal maturity.

An Efficient Robust Solution to the Two-Stage Stochastic Unit Commitment Problem

DEFF Research Database (Denmark)

Blanco, Ignacio; Morales González, Juan Miguel

2017-01-01

This paper proposes a reformulation of the scenario-based two-stage unitcommitment problem under uncertainty that allows finding unit-commitment plansthat perform reasonably well both in expectation and for the worst caserealization of the uncertainties. The proposed reformulation is based onpart...

COOLING STAGES OF CRYOGENIC SYSTEMS

OpenAIRE

Троценко, А. В.

2011-01-01

The formalized definition for cooling stage of low temperature system is done. Based on existing information about the known cryogenic unit cycles the possible types of cooling stages are single out. From analyses of these stages their classification by various characteristics is suggested. The results of thermodynamic optimization of final throttle stage of cooling, which are used as working fluids helium, hydrogen and nitrogen, are shown.

Ovarian chocolate cysts. Staging with relaxation time in MR imaging

Energy Technology Data Exchange (ETDEWEB)

Sugimura, Kazuro; Ishida, Tetsuya; Takemori, Masayuki; Kitagaki, Hajime; Tanaka, Yutaka; Yamasaki, Katsuhito; Shimizu, Tadafumi; Kono, Michio

1988-10-01

Accurate preoperative staging of ovarian chocolate cysts is very important because recent hormonal therapy has been effective in low stage patients. However, it has been difficult to assess the preoperative stage of ovarian chocolate cysts. We evaluated the diagnostic potential of MRI in preoperative staging of 15 overian chocolate cysts. It was well known that the older the ovarian chocolate cyst was the more iron content it had. We examined the iron contents effect on T1 and T2 relaxation times in surgically confirmed chocolate cysts (stage II: 3 cases, stage III: 3 cases and stage IV: 9 cases by AFS classification, 1985) employing the 0.15-T MR system and 200 MHz spectrometer. There was a positive linear relation between T1 of the lesion using the MR system (T1) and T1 of the resected contents using the spectrometer (sp-T1); r = 0.93. The same relation was revealed between T2 and sp-T2; r = 0.87. It was indicated that T1 and T2 using the MR system was accurate. There was a negative linear relation between T1 and the iron contents ( r = -0.81) but no relation between T2 and the iron contents. T1 was 412 +- 91 msec for stage II, 356 +- 126 msec for stage III and 208 +- 30 msec for stage IV. T1 for stage IV was shorter than that for stage II and III, statistically significant differences were noted (p < 0.05). Thus, T1 was useful in differentiating a fresh from an old ovarian chocolate cyst. We concluded that T1 relaxation time using the MR system was useful for the staging of an ovarian chocolate cyst without surgery.

Avascular necrosis of the femoral head; Staging by MR imaging

Energy Technology Data Exchange (ETDEWEB)

Kokubo, Takashi; Takatori, Yoshio; Ninomiya, Setsuo; Sasaki, Yasuhito [Tokyo Univ. (Japan). Faculty of Medicine

1993-03-01

Magnetic resonance (MR) images and conventional radiographs were compared in 142 hips with avascular necrosis, and a staging system for the disease based on MR imaging was developed. MR images were classified into three patterns: a band of low signal intensity (class I); an area of low signal intensity with internal spot(s) of high signal (class II); and an area of low signal intensity without internal spots of high signal (class III). Most MR class I lesions were in radiographic stage I (normal) or II (sclerotic or cystic changes without collapse). Most MR class II lesions were in radiographic stage III (segmental collapse), and most MR class III lesions were in stage III or IV (secondary degenerative changes). The MR image classification was closely correlated with radiographic staging (p<0.01, using [chi] square test). We considered that this classification closely reflected the different stages of the disease according to the histopathology of the bone marrow. (author).

Analysing outsourcing policies in an asset management context : A six-stage model

NARCIS (Netherlands)

Schoenmaker, R.; Verlaan, J.G.

2013-01-01

Asset managers of civil infrastructure are increasingly outsourcing their maintenance. Whereas maintenance is a cyclic process, decisions to outsource decisions are often project-based, and confusing the discussion on the degree of outsourcing. This paper presents a six-stage model that facilitates

Performance Analysis of Multi Stage Safety Injection Tank

International Nuclear Information System (INIS)

Shin, Soo Jai; Kim, Young In; Bae, Youngmin; Kang, Han-Ok; Kim, Keung Koo

2015-01-01

In general the integral reactor has such characteristics, the integral reactor requires a high flow rate of coolant safety injection at the initial stage of the accident in which the core level is relatively fast decreased, A medium flow rate of coolant safety injection at the early and middle stages of the accident in which the coolant discharge flow rate is relatively large due to a high internal pressure of the reactor vessel, and a low flow rate of coolant safety injection is required at the middle and late stages of the accident in which the coolant discharge flow rate is greatly reduced due to a decreased pressure of the reactor vessel. It is noted that a high flow rate of the integral reactor is quite smaller compared to a flow rate required in the commercial loop type reactor. However, a nitrogen pressurized safety injection tank has been typically designed to quickly inject a high flow rate of coolant when the internal pressure of the reactor vessel is rapidly decreased, and a core makeup tank has been designed to safely inject at a single mode flow rate due to a gravitational head of water subsequent to making a pressure balance between the reactor vessel and core makeup tank. As a result, in order to compensate such a disadvantage, various type systems are used in a complicated manner in a reactor according to the required characteristic of safety injection during an accident. In the present study, we have investigated numerically the performance of the multi stage safety injection tank. A parameter study has performed to understand the characteristics of the multi stage safety injection tank. The performance of the multi stage safety injection tank has been investigated numerically. When an accident occurs, the coolant in the multi stage safety injection tank is injected into a reactor vessel by a gravitational head of water subsequent to making a pressure balance between the reactor and tank. At the early stages of the accident, the high flow rate of

Performance Analysis of Multi Stage Safety Injection Tank

Energy Technology Data Exchange (ETDEWEB)

Shin, Soo Jai; Kim, Young In; Bae, Youngmin; Kang, Han-Ok; Kim, Keung Koo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-10-15

In general the integral reactor has such characteristics, the integral reactor requires a high flow rate of coolant safety injection at the initial stage of the accident in which the core level is relatively fast decreased, A medium flow rate of coolant safety injection at the early and middle stages of the accident in which the coolant discharge flow rate is relatively large due to a high internal pressure of the reactor vessel, and a low flow rate of coolant safety injection is required at the middle and late stages of the accident in which the coolant discharge flow rate is greatly reduced due to a decreased pressure of the reactor vessel. It is noted that a high flow rate of the integral reactor is quite smaller compared to a flow rate required in the commercial loop type reactor. However, a nitrogen pressurized safety injection tank has been typically designed to quickly inject a high flow rate of coolant when the internal pressure of the reactor vessel is rapidly decreased, and a core makeup tank has been designed to safely inject at a single mode flow rate due to a gravitational head of water subsequent to making a pressure balance between the reactor vessel and core makeup tank. As a result, in order to compensate such a disadvantage, various type systems are used in a complicated manner in a reactor according to the required characteristic of safety injection during an accident. In the present study, we have investigated numerically the performance of the multi stage safety injection tank. A parameter study has performed to understand the characteristics of the multi stage safety injection tank. The performance of the multi stage safety injection tank has been investigated numerically. When an accident occurs, the coolant in the multi stage safety injection tank is injected into a reactor vessel by a gravitational head of water subsequent to making a pressure balance between the reactor and tank. At the early stages of the accident, the high flow rate of

Cervical Cancer Stage IIIB

Science.gov (United States)

... by the cancer. This blockage can cause the kidney to enlarge or stop working. Stage IIIB cervical cancer. Topics/Categories: Anatomy -- Gynecologic Cancer Types -- Cervical Cancer Staging Type: Color, ...

Staged deployment of the International Fusion Materials Irradiation Facility

International Nuclear Information System (INIS)

Takeuchi, H.; Sugimoto, M.; Nakamura, H.

2001-01-01

The International Fusion Materials Irradiation Facility (IFMIF) employs an accelerator based D-Li intense neutron source as defined in the 1995-96 Conceptual Design Activity (CDA) study. In 1999, IEA mandated a review of the CDA IFMIF design for cost reduction without change to its original mission. This objective was accomplished by eliminating the previously assumed possibility of potential upgrade of IFMIF beyond the user requirements. The total estimated cost was reduced from $797.2 M to $487.8 M. An option of deployment in 3 stages was also examined to reduce the initial investment and annual expenditures during construction. In this scenario, full performance is achieved gradually with each interim stage as follows. 1st Stage: 20% operation for material selection for ITER breeding blanket, 2nd Stage: 50% operation to demonstrate materials performance of a reference alloy for DEMO, 3rd Stage: full performance operation ( 2MW/m 2 at 500cm 3 ) to obtain engineering data for potential DEMO materials under irradiation up to 100-200 dpa. In summary, the new, reduced cost IFMIF design and staged deployment still satisfies the original mission. The estimated cost of the 1st Stage facility is only $303.6 M making it financially much more attractive. Currently, IFMIF Key Element Technology Phase (KEP) is underway to reduce the key technology risk factors. (author)

Dilemmas in Lung Cancer Staging.

Science.gov (United States)

Vlahos, Ioannis

2018-05-01

The advent of the 8th edition of the lung cancer staging system reflects a further meticulous evidence-based advance in the stratification of the survival of patients with lung cancer. Although addressing many limitations of earlier staging systems, several limitations in staging remain. This article reviews from a radiological perspective the limitations of the current staging system, highlighting the process of TNM restructuring, the residual issues with regards to the assignment of T, N, M descriptors, and their associated stage groupings and how these dilemmas impact guidance of multidisciplinary teams taking care of patients with lung cancer. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Accuracy of preoperative CT T staging of renal cell carcinoma: which features predict advanced stage?

International Nuclear Information System (INIS)

Bradley, A.J.; MacDonald, L.; Whiteside, S.; Johnson, R.J.; Ramani, V.A.C.

2015-01-01

Aims: To characterise CT findings in renal cell carcinoma (RCC), and establish which features are associated with higher clinical T stage disease, and to evaluate patterns of discrepancy between radiological and pathological staging of RCC. Materials and methods: Preoperative CT studies of 92 patients with 94 pathologically proven RCCs were retrospectively reviewed. CT stage was compared with pathological stage using the American Joint Committee on Cancer (AJCC), 7 th edition (2010). The presence or absence of tumour necrosis, perinephric fat standing, thickening of Gerota's fascia, collateral vessels were noted, and correlated with pT stage. The sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) for predicting pT stage ≥pT3a were derived separately for different predictors using cross-tabulations. Results: Twenty-four lesions were pathological stage T1a, 21 were T1b, seven were T2a, 25 were T3a, 11 were T3b, four were T3c, and two were T4. There were no stage T2b. Sixty-three (67%) patients had necrosis, 27 (29%) thickening of Gerota's fascia (1 T1a), 25 had collateral vessels (0 T1a), 28 (30%) had fat stranding of <2 mm, 20 (21%) of 2–5mm and one (1%) of >5 mm. For pT stage ≥pT3a, the presence of perinephric fat stranding had a sensitivity, specificity, PPV and NPV of 74%, 65%, 63%, and 76%, respectively. Presence of tumour necrosis had a sensitivity, specificity, PPV, and NPV of 81%, 44%, 54%, and 72%, respectively. Thickening of Gerota's fascia had a sensitivity, specificity, PPV, and NPV of 52%, 90%, 81% and 70%, respectively; and enlarged collateral vessels had a sensitivity, specificity, PPV, and NPV value of 52%, 94%, 88%, and 71% respectively. Conclusion: The presence of perinephric stranding and tumour necrosis were not reliable signs for pT stage >T3a. Thickening of Gerota's fascia and the presence of collateral vessels in the peri- or paranephric fat had 90% and 94% specificity, with 82% and 88

Possibilities Of Opening Up the Stage-Gate Model

Directory of Open Access Journals (Sweden)

Biljana Stošić

2014-12-01

Full Text Available The paper presents basic elements of the Stage-Gate and Open innovation models, and possible connection of these two, resulting in what is frequently called an “Open Stage-Gate” model. This connection is based on opening up the new product development process and integration of the open innovation principles with the Stage-Gate concept, facilitating the import and export of information and technologies. Having in mind that the Stage Gate has originally been classified as the third generation model of innovation, the paper is dealing with the capabilities for applying the sixth generation Open innovation principles in today’s improved and much more flexible phases and gates of the Stage Gate. Lots of innovative companies are actually using both models in their NPD practice, looking for the most appropriate means of opening up the well-known closed innovation, especially in the domain of ideation through co-creation.

Acoustical measurements of sound fields between the stage and the orchestra pit inside an historical opera house

Science.gov (United States)

Sato, Shin-Ichi; Prodi, Nicola; Sakai, Hiroyuki

2004-05-01

To clarify the relationship of the sound fields between the stage and the orchestra pit, we conducted acoustical measurements in a typical historical opera house, the Teatro Comunale of Ferrara, Italy. Orthogonal factors based on the theory of subjective preference and other related factors were analyzed. First, the sound fields for a singer on the stage in relation to the musicians in the pit were analyzed. And then, the sound fields for performers in the pit in relation to the singers on the stage were considered. Because physical factors vary depending on the location of the sound source, performers can move on the stage or in the pit to find the preferred sound field.

Core compressor exit stage study. 1: Aerodynamic and mechanical design

Science.gov (United States)

Burdsall, E. A.; Canal, E., Jr.; Lyons, K. A.

1979-01-01

The effect of aspect ratio on the performance of core compressor exit stages was demonstrated using two three stage, highly loaded, core compressors. Aspect ratio was identified as having a strong influence on compressors endwall loss. Both compressors simulated the last three stages of an advanced eight stage core compressor and were designed with the same 0.915 hub/tip ratio, 4.30 kg/sec (9.47 1bm/sec) inlet corrected flow, and 167 m/sec (547 ft/sec) corrected mean wheel speed. The first compressor had an aspect ratio of 0.81 and an overall pressure ratio of 1.357 at a design adiabatic efficiency of 88.3% with an average diffusion factor or 0.529. The aspect ratio of the second compressor was 1.22 with an overall pressure ratio of 1.324 at a design adiabatic efficiency of 88.7% with an average diffusion factor of 0.491.

The Three Stages of Critical Policy Methodology: An Example from Curriculum Analysis

Science.gov (United States)

Rata, Elizabeth

2014-01-01

The article identifies and discusses three stages in the critical policy methodology used in the sociology of education. These are: firstly, employing a political economy theoretical framework that identifies causal links between global forces and local developments; secondly, analysing educational policy within that theoretically conceptualised…

Parenchymal neurocysticercosis: follow-up and staging by MRI

International Nuclear Information System (INIS)

Dumas, J.L.; Visy, J.M.; Belin, C.; Gaston, A.; Goldlust, D.; Dumas, M.

1997-01-01

We describe the evolution of parenchymal cerebral cysticerci on MRI, to assess signs of early cyst degeneration. We studied 15 lesions in four treated and one untreated patient. MRI was performed before therapy and repeated in the 1st month after each course of anticysticercus drugs, every 4 months during the 1st year and then annually; the follow-up period was 8-48 months. Lesions were classified according to changes in four features: cyst content and capsule signal, gadolinium enhancement and oedema signal. We were able to recognise each of the pathological phases; five MRI stages were identified. Stage 1 showed oedema and/or nodular gadolinium enhancement in the tissue invasion phase; stage 2 was cerebrospinal fluid-like signal within a cyst in the vesicular phase; stage 3 showed a thick capsule with an impure liquid content signal and surrounding oedema, in the cystic phase; stage 4 showed the disappearance of the cyst fluid content signal in the degenerative phase; stage 5 showed a calcified lesion in the residual phase. Stage 1 lesions disappeared after therapy; the other progressed from one stage to another. Stage 4 indicated the end of viability of the parasite and determined the point after which treatment was useless. On T2-weighted images changes in the cyst content differed according to the history of the lesion; nodular low intensity followed the natural degeneration of the parasite and a mixed fluid signal with punctate low signal seemed to represent the specific result of therapy. MRI staging can help in the evaluation of indications for treatment and facilitate clinical therapeutic trials. (orig.). With 4 figs., 1 tab

Appendectomy in the surgical staging of ovarian carcinoma.

Science.gov (United States)

Beşe, T; Kösebay, D; Kaleli, S; Oz, A U; Demirkiran, F; Gezer, A

1996-06-01

Extensive debulking is accepted as the primary method of operative management for carcinoma of the ovary. However, there is no consensus regarding the role of appendectomy in primary surgical treatment. The aim of this study was to assess the role of appendectomy in the surgical staging and cytoreduction of ovarian carcinoma. The study was a retrospective review of 90 primary malignant ovarian carcinoma patients who had an appendectomy in addition to primary cytoreductive surgery. Out of 90 patients, 10 (11.1%) had metastasis to the appendix. The rate of metastasis to the appendix was 11.5% (9/78) in malignant epithelial ovarian carcinomas and 8.3% (1/12) in non-epithelial ovarian tumors. Of the patients with metastasis in the appendix, malignant epithelial ovarian tumors were identified in 90% (serous: 70%; clear cell: 20%), and non-epithelial malignant ovarian tumor were disclosed in 10% (granulosa cell carcinoma). There were no metastases to the appendix in the other histological types. Although metastasis to the appendix was not observed in early stage ovarian carcinomas, it was detected in 21.4% (9/42) of stage III and 50% (1/2) of stage IV. Macroscopic tumor metastasis in the abdomen was noted in all patients with metastasis to the appendix. Appendectomy for stage I and II patients was not beneficial and did not affect final staging. As a result, for the proper staging of ovarian carcinoma there is no advantage to the addition of routine appendectomy to primary cytoreductive surgery in early stage (stage I and II) malignant epithelial ovarian tumors. Appendectomy would contribute to the cytoreduction of advanced stage disease if it is macroscopically involved.

Parenchymal neurocysticercosis: follow-up and staging by MRI

Energy Technology Data Exchange (ETDEWEB)

Dumas, J.L. [Dept. of Radiology, Hopital Avicenne, Bobigny (France)]|[Inst. of Tropical Neurology, Faculty of Medicine, Limoges (France); Visy, J.M. [Dept. of Neurology, Hopital Lariboisiere, Paris (France); Belin, C. [Dept. of Neurology, Hopital Avicenne, Bobigny (France); Gaston, A. [Dept. of Neuroradiology, Hopital Henri-Mondor, Creteil (France); Goldlust, D. [Dept. of Radiology, Hopital Avicenne, Bobigny (France); Dumas, M. [Inst. of Tropical Neurology, Faculty of Medicine, Limoges (France)

1997-01-01

We describe the evolution of parenchymal cerebral cysticerci on MRI, to assess signs of early cyst degeneration. We studied 15 lesions in four treated and one untreated patient. MRI was performed before therapy and repeated in the 1st month after each course of anticysticercus drugs, every 4 months during the 1st year and then annually; the follow-up period was 8-48 months. Lesions were classified according to changes in four features: cyst content and capsule signal, gadolinium enhancement and oedema signal. We were able to recognise each of the pathological phases; five MRI stages were identified. Stage 1 showed oedema and/or nodular gadolinium enhancement in the tissue invasion phase; stage 2 was cerebrospinal fluid-like signal within a cyst in the vesicular phase; stage 3 showed a thick capsule with an impure liquid content signal and surrounding oedema, in the cystic phase; stage 4 showed the disappearance of the cyst fluid content signal in the degenerative phase; stage 5 showed a calcified lesion in the residual phase. Stage 1 lesions disappeared after therapy; the other progressed from one stage to another. Stage 4 indicated the end of viability of the parasite and determined the point after which treatment was useless. On T2-weighted images changes in the cyst content differed according to the history of the lesion; nodular low intensity followed the natural degeneration of the parasite and a mixed fluid signal with punctate low signal seemed to represent the specific result of therapy. MRI staging can help in the evaluation of indications for treatment and facilitate clinical therapeutic trials. (orig.). With 4 figs., 1 tab.

Staging of gastric adenocarcinoma using two-phase spiral CT: correlation with pathologic staging

International Nuclear Information System (INIS)

Seo, Tae Seok; Lee, Dong Ho; Ko, Young Tae; Lim, Joo Won

1998-01-01

To correlate the preoperative staging of gastric adenocarcinoma using two-phase spiral CT with pathologic staging. One hundred and eighty patients with gastric cancers confirmed during surgery underwent two-phase spiral CT, and were evaluated retrospectively. CT scans were obtained in the prone position after ingestion of water. Scans were performed 35 and 80 seconds after the start of infusion of 120mL of non-ionic contrast material with the speed of 3mL/sec. Five mm collimation, 7mm/sec table feed and 5mm reconstruction interval were used. T-and N-stage were determined using spiral CT images, without knowledge of the pathologic results. Pathologic staging was later compared with CT staging. Pathologic T-stage was T1 in 70 cases(38.9%), T2 in 33(18.3%), T3 in 73(40.6%), and T4 in 4(2.2%). Type-I or IIa elevated lesions accouted for 10 of 70 T1 cases(14.3%) and flat or depressed lesions(type IIb, IIc, or III) for 60(85.7%). Pathologic N-stage was NO in 85 cases(47.2%), N1 in 42(23.3%), N2 in 31(17.2%), and N3 in 22(12,2%). The detection rate of early gastric cancer using two-phase spiral CT was 100.0%(10 of 10 cases) among elevated lesions and 78.3%(47 of 60 cases) among flat or depressed lesions. With regard to T-stage, there was good correlation between CT image and pathology in 86 of 180 cases(47.8%). Overstaging occurred in 23.3%(42 of 180 cases) and understaging in 28.9%(52 of 180 cases). With regard to N-stage, good correlation between CT image and pathology was noted in 94 of 180 cases(52.2%). The rate of understaging(31.7%, 57 of 180 cases) was higher than that of overstaging(16.1%, 29 of 180 cases)(p<0.001). The detection rate of early gastric cancer using two-phase spiral CT was 81.4%, and there was no significant difference in detectability between elevated and depressed lesions. Two-phase spiral CT for determing the T-and N-stage of gastric cancer was not effective;it was accurate in abont 50% of cases understaging tended to occur.=20

Clinical verification of the superiority of the current International Union Against Cancer staging criteria in an Australian population of patients with nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Corry, J.; Porceddu, S.; Peters, L.J.; Fisher, R.; Rischin, D.

2004-01-01

The purpose of this study is to assess the prognostic abilities of the fourth and fifth edition International Union Against Cancer (UICC) staging systems for nasopharyngeal carcinoma (NPC) in Australian patients. All patients planned for curative treatment at the Peter MacCallum Cancer Centre from April 1985 to December 1999 were included in this study. There were 181 patients eligible for this study. The median follow up was 7.6 years. Histological subgroups were World Health Organization (WHO) 1 (23), WHO 2 (12), and WHO 3 (146). Presentation with stage IV disease was 83% by UICC fourth edition staging and 34% by UICC fifth edition staging. The 5 years failure-free survival (FFS) rates for stage 1, 2, 3 and 4 disease by the fourth edition was 77, 100, 93, and 49% respectively,and by the fifth edition was 85, 76. 57 and 36%, respectively. The 5 years overall survival (OS) for stage 1, 2, 3, and 4 disease by the fourth edition was 77. 100, 100 and 61%; respectively.and by the fifth edition was 85, 82, 67 and 53%, respectively. Stage 4 patients by the fourth edition were reclassified as stages 2, 3 and 4 by the fifth edition with hazard ratios of 0.77, 1.01 and 1.79, respectively. In multifactor analysis, the fifth edition staging system was significantly related to FFS and OS after allowing for the fourth edition (FFS: P= 0.002; OS: P = 0.005), but the fourth edition was not significantly related to FFS or OS after allowing for the fifth edition (FFS: P = 0.96; OS: P = 0.96). This study confirms the prognostic superiority of the fifth edition UICC staging system over the fourth edition staging system in an Australian NPC population. Copyright (2004) Blackwell Science Pty Ltd

Early-stage mantle cell lymphoma

DEFF Research Database (Denmark)

Dabaja, B S; Zelenetz, A D; Ng, A K

2017-01-01

Background: Mantle cell lymphoma (MCL) rarely presents as early-stage disease, but clinical observations suggest that patients who present with early-stage disease may have better outcomes than those with advanced-stage disease. Patients and methods: In this 13-institution study, we examined...

Resilient data staging through MxN distributed transactions.

Energy Technology Data Exchange (ETDEWEB)

Schwan, Karsten (Georgia Institute of Technology, Atlanta, GA); Oldfield, Ron A.; Lofstead, Gerald Fredrick, II; Dayal, Jai (Georgia Institute of Technology, Atlanta, GA)

2011-11-01

Scientific computing-driven discoveries are frequently driven from workflows that use persistent storage as a staging area for data between operations. With the bad and progressively worse bandwidth vs. data size issues as we continue towards exascale, eliminating persistent storage through techniques like data staging will both enable these workflows to continue online, but also enable more interactive workflows reducing the time to scientific discoveries. Data staging has shown to be an effective way for applications running on high-end computing platforms to offload expensive I/O operations and to manage the tremendous amounts of data they produce. This data staging approach, however, lacks the ACID style guarantees traditional straight-to-disk methods provide. Distributed transactions are a proven way to add ACID properties to data movements, however distributed transactions follow 1xN data movement semantics, where our highly parallel HPC environments employ MxN data movement semantics. In this paper we present a novel protocol that extends distributed transaction terminology to include MxN semantics which allows our data staging areas to benefit from ACID properties. We show that with our protocol we can provide resilient data staging with a limited performance penalty over current data staging implementations.

Stage measurement at gaging stations

Science.gov (United States)

Sauer, Vernon B.; Turnipseed, D. Phil

2010-01-01

Stream and reservoir stage are critical parameters in the computation of stream discharge and reservoir volume, respectively. In addition, a record of stream stage is useful in the design of structures that may be affected by stream elevation, as well as for the planning for various uses of flood plains. This report describes equipment and methodology for the observation, sensing, and recording of stage in streams and reservoirs. Although the U.S. Geological Survey (USGS) still uses the traditional, basic stilling-well float system as a predominant gaging station, modern electronic stage sensors and water-level recorders are now commonly used. Bubble gages coupled with nonsubmersible pressure transducers eliminate the need for stilling wells. Submersible pressure transducers have become common in use for the measurement of stage in both rivers and lakes. Furthermore, noncontact methods, such as radar, acoustic, and laser methods of sensing water levels, are being developed and tested, and in the case of radar, are commonly used for the measurement of stage. This report describes commonly used gaging-station structures, as well as the design and operation of gaging stations. Almost all of the equipment and instruments described in this report will meet the accuracy standard set by the USGS Office of Surface Water (OSW) for the measurement of stage for most applications, which is ±0.01 foot (ft) or 0.2 percent of the effective stage. Several telemetry systems are used to transmit stage data from the gaging station to the office, although satellite telemetry has become the standard. These telemetry systems provide near real-time stage data, as well as other information that alerts the hydrographer to extreme or abnormal events, and instrument malfunctions.

Automatic staging of bladder cancer on CT urography

Science.gov (United States)

Garapati, Sankeerth S.; Hadjiiski, Lubomir M.; Cha, Kenny H.; Chan, Heang-Ping; Caoili, Elaine M.; Cohan, Richard H.; Weizer, Alon; Alva, Ajjai; Paramagul, Chintana; Wei, Jun; Zhou, Chuan

2016-03-01

Correct staging of bladder cancer is crucial for the decision of neoadjuvant chemotherapy treatment and minimizing the risk of under- or over-treatment. Subjectivity and variability of clinicians in utilizing available diagnostic information may lead to inaccuracy in staging bladder cancer. An objective decision support system that merges the information in a predictive model based on statistical outcomes of previous cases and machine learning may assist clinicians in making more accurate and consistent staging assessments. In this study, we developed a preliminary method to stage bladder cancer. With IRB approval, 42 bladder cancer cases with CTU scans were collected from patient files. The cases were classified into two classes based on pathological stage T2, which is the decision threshold for neoadjuvant chemotherapy treatment (i.e. for stage >=T2) clinically. There were 21 cancers below stage T2 and 21 cancers at stage T2 or above. All 42 lesions were automatically segmented using our auto-initialized cascaded level sets (AI-CALS) method. Morphological features were extracted, which were selected and merged by linear discriminant analysis (LDA) classifier. A leave-one-case-out resampling scheme was used to train and test the classifier using the 42 lesions. The classification accuracy was quantified using the area under the ROC curve (Az). The average training Az was 0.97 and the test Az was 0.85. The classifier consistently selected the lesion volume, a gray level feature and a contrast feature. This predictive model shows promise for assisting in assessing the bladder cancer stage.

End-stage kidney disease

Science.gov (United States)

... stage; Kidney failure - end stage; ESRD; ESKD Images Kidney anatomy References Fogarty DG, Taal MW. A stepped care approach to the management of chronic kidney disease. In: Skorecki K, Chertow GM, Marsden PA, ...

CT staging of colon cancer

International Nuclear Information System (INIS)

Dighe, S.; Swift, I.; Brown, G.

2008-01-01

Computer tomography (CT) has been the principal investigation in the staging of colon cancers. The information obtained with routine CT has been limited to identifying the site of the tumour, size of the tumour, infiltration into surrounding structures and metastatic spread. The Foxtrot trial National Cancer Research Institute (NCRI) has been specifically designed to evaluate the efficacy of neoadjuvant treatment in colon cancers by using preoperative chemotherapy with or without an anti-Epidermal Growth Factor Receptor (EGFR) monoclonal antibody to improve outcome in high-risk operable colon cancer. Patients are selected based on their staging CT examination. The criteria for poor prognosis are T4 and T3 tumours with more than 5 mm extramural depth. Thus the success of the trial would depend upon the confidence of the radiologist to identify the patients that would receive the neoadjuvant treatment. The aim of this review is to explain the process of identifying high-risk features seen on the staging CT images. This will help to identify a cohort of patients that could truly benefit from neoadjuvant strategies

CT staging of colon cancer

Energy Technology Data Exchange (ETDEWEB)

Dighe, S. [Department of Radiology, Royal Marsden Hospital, Sutton SM5 2TT (United Kingdom); Swift, I. [Department of Surgery, Mayday University Hospital, Croydon CR7 7YE (United Kingdom); Brown, G. [Department of Radiology, Royal Marsden Hospital, Sutton SM5 2TT (United Kingdom)], E-mail: gina.brown@rmh.nhs.uk

2008-12-15

Computer tomography (CT) has been the principal investigation in the staging of colon cancers. The information obtained with routine CT has been limited to identifying the site of the tumour, size of the tumour, infiltration into surrounding structures and metastatic spread. The Foxtrot trial National Cancer Research Institute (NCRI) has been specifically designed to evaluate the efficacy of neoadjuvant treatment in colon cancers by using preoperative chemotherapy with or without an anti-Epidermal Growth Factor Receptor (EGFR) monoclonal antibody to improve outcome in high-risk operable colon cancer. Patients are selected based on their staging CT examination. The criteria for poor prognosis are T4 and T3 tumours with more than 5 mm extramural depth. Thus the success of the trial would depend upon the confidence of the radiologist to identify the patients that would receive the neoadjuvant treatment. The aim of this review is to explain the process of identifying high-risk features seen on the staging CT images. This will help to identify a cohort of patients that could truly benefit from neoadjuvant strategies.

Staged fluidized-bed combustion and filter system

International Nuclear Information System (INIS)

Mei, J.S.; Halow, J.S.

1994-01-01

A staged fluidized-bed combustion and filter system are described for substantially reducing the quantity of waste through the complete combustion into ash-type solids and gaseous products. The device has two fluidized-bed portions, the first primarily as a combustor/pyrolyzer bed, and the second as a combustor/filter bed. The two portions each have internal baffles to define stages so that material moving therein as fluidized beds travel in an extended route through those stages. Fluidization and movement is achieved by the introduction of gases into each stage through a directional nozzle. Gases produced in the combustor/pyrolyzer bed are permitted to travel into corresponding stages of the combustor/filter bed through screen filters that permit gas flow but inhibit solids flow. Any catalyst used in the combustor/filter bed is recycled. The two beds share a common wall to minimize total volume of the system. A slightly modified embodiment can be used for hot gas desulfurization and sorbent regeneration. Either side-by-side rectangular beds or concentric beds can be used. The system is particularly suited to the processing of radioactive and chemically hazardous waste. 10 figures

Tumor angiogenesis in advanced stage ovarian carcinoma.

Science.gov (United States)

Hollingsworth, H C; Kohn, E C; Steinberg, S M; Rothenberg, M L; Merino, M J

1995-07-01

Tumor angiogenesis has been found to have prognostic significance in many tumor types for predicting an increased risk of metastasis. We assessed tumor vascularity in 43 cases of advanced stage (International Federation of Gynecologists and Obstetricians stages III and IV) ovarian cancer by using the highly specific endothelial cell marker CD34. Microvessel counts and stage were associated with disease-free survival and with overall survival by Kaplan-Meier analysis. The plots show that higher stage, higher average vessel count at 200x (200x avg) and 400x (400x avg) magnification and highest vessel count at 400x (400x high) magnification confer a worse prognosis for disease-free survival. Average vessel count of less than 16 (400x avg, P2 = 0.01) and less than 45 (200x avg, P2 = 0.026) suggested a better survival. Similarly, a high vessel count of less than 20 (400x high, P2 = 0.019) conferred a better survival as well. The plots suggest that higher stage, higher average vessel count at 200x and 400x, and highest vessel count at 200x and 400x show a trend to worse overall survival as well. With the Cox proportional hazards model, stage was the best predictor of overall survival, however, the average microvessel count at 400x was found to be the best predictor of disease-free survival. These results suggest that analysis of neovascularization in advanced stage ovarian cancer may be a useful prognostic factor.

Marketing potential evaluation at the analytical stage of marketing audit of an enterprise

OpenAIRE

Fayzulaueva, K.

2011-01-01

In the article the sequence of analytical stage of marketing audit by means of marketing potential evaluation is considered, the qualitative characteristics and indicators of marketing potential evaluation are determined.

Nano positioning control for dual stage using minimum order observer

International Nuclear Information System (INIS)

Kim, Hong Gun

2012-01-01

A nano positioning control is developed using the ultra-precision positioning apparatus such as actuator, sensor, guide, power transmission element with an appropriate control method. Using established procedures, a single plane X-Y stage with ultra-precision positioning is manufactured. A global stage for materialization with robust system is combined by using an AC servo motor with a ball screw and rolling guide. An ultra-precision positioning system is developed using a micro stage with an elastic hinge and piezo element. Global and micro servos for positioning with nanometer accuracy are controlled simultaneously using an incremental encoder and a laser interferometer to measure displacement. Using established procedures, an ultra-precision positioning system (100 mm stroke and ±10 nm positioning accuracy) with a single plane X-Y stage is fabricated. Its performance is evaluated through simulation using Matlab. After analyzing previous control algorithms and adapting modern control theory, a dual servo algorithm is developed for a minimum order observer to secure the stability and priority on the controller. The simulations and experiments on the ultra precision positioning and the stability of the ultra-precision positioning system with single plane X-Y stage and the priority of the control algorithm are secured by using Matlab with Simulink and ControlDesk made in dSPACE

Nano positioning control for dual stage using minimum order observer

Energy Technology Data Exchange (ETDEWEB)

Kim, Hong Gun [Jeonju University, Jeonju (Korea, Republic of)

2012-03-15

A nano positioning control is developed using the ultra-precision positioning apparatus such as actuator, sensor, guide, power transmission element with an appropriate control method. Using established procedures, a single plane X-Y stage with ultra-precision positioning is manufactured. A global stage for materialization with robust system is combined by using an AC servo motor with a ball screw and rolling guide. An ultra-precision positioning system is developed using a micro stage with an elastic hinge and piezo element. Global and micro servos for positioning with nanometer accuracy are controlled simultaneously using an incremental encoder and a laser interferometer to measure displacement. Using established procedures, an ultra-precision positioning system (100 mm stroke and {+-}10 nm positioning accuracy) with a single plane X-Y stage is fabricated. Its performance is evaluated through simulation using Matlab. After analyzing previous control algorithms and adapting modern control theory, a dual servo algorithm is developed for a minimum order observer to secure the stability and priority on the controller. The simulations and experiments on the ultra precision positioning and the stability of the ultra-precision positioning system with single plane X-Y stage and the priority of the control algorithm are secured by using Matlab with Simulink and ControlDesk made in dSPACE.

Ages and stages questionnaires: adaptation to an Arabic speaking population and cultural sensitivity.

Science.gov (United States)

Charafeddine, Lama; Sinno, Durriyah; Ammous, Farah; Yassin, Walid; Al-Shaar, Laila; Mikati, Mohamad A

2013-09-01

Early detection of developmental delay is essential to initiate early intervention. The Ages and Stages Questionnaires (ASQ) correlate well with physician's assessment and have high predictive value. No such tool exists in Arabic. Translate and test the applicability and reliability of Arabic translated Ages and Stages Questionnaires (A-ASQ) in an Arabic speaking population. 733 healthy children were assessed. ASQ-II for 10 age groups (4-60 months) were translated to Arabic, back translations and cultural adaptation were performed. Test-retest reliability and internal consistency were evaluated using Pearson Correlation Coefficient (CC) and Cronbach's alpha (Cα). Mean scores per domain were compared to US normative scores using t-test. A-ASQ, after culturally relevant adaptations, was easily administered for 4-36 months age groups but not for 4-5 year old due to numerous cultural differences in the later. For the 4-36 month age groups Pearson CC ranged from 0.345 to 0.833. The internal consistency coefficients Cα scores ranged from 0.111 to 0.816. Significant differences were found in the mean domain scores of all age groups between Lebanese and US normative sample (p-value internal consistency and reliability in the younger age groups. It proved to be culturally sensitive, which should be taken into consideration when adapting such tool to non-western populations. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

A stage-based model of design teaching

DEFF Research Database (Denmark)

Beier, Sofie

2014-01-01

With a focus on the teaching of design students in higher education, the article will present a teaching approach model that follows the stages of the design process. The model suggests that at the Definition stage, the supervisor can focus on leading the student into a more thorough elaboration ...... apply an approach inspired by the master–apprentice relationship, where the student learns by observing the master at work....

Second stage of Saturn V being assembled with the first stage.

Science.gov (United States)

1965-01-01

The hydrogen-powered second stage is being lowered into place during the final phase of fabrication of the Saturn V moon rocket at North American's Seal Beach, California facility. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

Comparison of outcomes in patients with stage III versus limited stage IV non-small cell lung cancer

International Nuclear Information System (INIS)

Cheruvu, Praveena; Metcalfe, Su K; Metcalfe, Justin; Chen, Yuhchyau; Okunieff, Paul; Milano, Michael T

2011-01-01

Standard therapy for metastatic non small cell lung cancer (NSCLC) includes palliative systemic chemotherapy and/or radiotherapy. Recent studies of patients with limited metastases treated with curative-intent stereotactic body radiation therapy (SBRT) have shown encouraging survival. We hypothesized that patients treated with SBRT for limited metastases have comparable outcomes with those treated with curative-intent radiation for Stage III NSCLC. We retrospectively reviewed the records of NSCLC patients treated with curative-intent radiotherapy at the University of Rochester from 2000-2008. We identified 3 groups of patients with NSCLC: stage III, stage IV, and recurrent stage IV (initial stage I-II). All stage IV NSCLC patients treated with SBRT had ≤ 8 lesions. Of 146 patients, 88% had KPS ≥ 80%, 30% had > 5% weight loss, and 95% were smokers. The 5-year OS from date of NSCLC diagnosis for stage III, initial stage IV and recurrent stage IV was 7%, 14%, and 27% respectively. The 5-year OS from date of metastatic diagnosis was significantly (p < 0.00001) superior among those with limited metastases (≤ 8 lesions) versus stage III patients who developed extensive metastases not amenable to SBRT (14% vs. 0%). Stage IV NSCLC is a heterogeneous patient population, with a selected cohort apparently faring better than Stage III patients. Though patients with limited metastases are favorably selected by virtue of more indolent disease and/or less bulky disease burden, perhaps staging these patients differently is appropriate for prognostic and treatment characterization. Aggressive local therapy may be indicated in these patients, though prospective clinical studies are needed

Clinical and endorectal ultrasound staging of circumferential rectal cancers

International Nuclear Information System (INIS)

Smith, A.; Farmer, K.C.; Chapple, K.

2008-01-01

Full text: Circumferential rectal cancers present at a more advanced stage than those located in a single quadrant. Although accurate staging is an important aspect of the preoperative management of the patient with a rectal cancer, the clinical and radiological staging of this subgroup of rectal cancer patients has been poorly studied. All patients with a rectal cancer were assessed clinically (by digital rectal examination and rigid sigmoidoscopy) before the radiological assessment by endorectal ultrasound (ERUS). Data collected included tumour height (distance from anal verge in centimetre) and tumour type (circumferential or non-circumferential). Radiological tumour staging was with the TNM system. Fifty-nine subjects (33 men, 26 women; median age 65 years (range 38-86 years)) were identified with a circumferential rectal cancer. Mean height of the cancer was 8 - 0.4 cm (standard error of the mean; range 2-13 cm). Forty-two cancers were palpable, and 17 cancers were impalpable. All cancers assessed clinically as circumferential were confirmed as circumferential on ERUS scanning. Tumour stage as assessed by ERUS was either T3 (n = 57) or T4 (n = 2). Nodal status was NO (n = 29) and N1 (n = 30). All rectal cancers assessed as circumferential on clinical examination have an ERUS stage of T3 or greater.

Comparison of Oone-Stage Free Gracilis Muscle Flap With Two-Stage Method in Chronic Facial Palsy

Directory of Open Access Journals (Sweden)

J Ghaffari

2007-08-01

Full Text Available Background:Rehabilitation of facial paralysis is one of the greatest challenges faced by reconstructive surgeons today. The traditional method for treatment of patients with facial palsy is the two-stage free gracilis flap which has a long latency period of between the two stages of surgery.Methods: In this paper, we prospectively compared the results of the one-stage gracilis flap method with the two -stage technique.Results:Out of 41 patients with facial palsy refered to Hazrat-e-Fatemeh Hospital 31 were selected from whom 22 underwent two- stage and 9 one-stage method treatment. The two groups were identical according to age,sex,intensity of illness, duration, and chronicity of illness. Mean duration of follow up was 37 months. There was no significant relation between the two groups regarding the symmetry of face in repose, smiling, whistling and nasolabial folds. Frequency of complications was equal in both groups. The postoperative surgeons and patients' satisfaction were equal in both groups. There was no significant difference between the mean excursion of muscle flap in one-stage (9.8 mm and two-stage groups (8.9 mm. The ratio of contraction of the affected side compared to the normal side was similar in both groups. The mean time of the initial contraction of the muscle flap in the one-stage group (5.5 months had a significant difference (P=0.001 with the two-stage one (6.5 months.The study revealed a highly significant difference (P=0.0001 between the mean waiting period from the first operation to the beginning of muscle contraction in one-stage(5.5 monthsand two-stage groups(17.1 months.Conclusion:It seems that the results and complication of the two methods are the same,but the one-stage method requires less time for facial reanimation,and is costeffective because it saves time and decreases hospitalization costs.

Comparing a single-stage geocoding method to a multi-stage geocoding method: how much and where do they disagree?

Directory of Open Access Journals (Sweden)

Rice Kenneth

2007-03-01

Full Text Available Abstract Background Geocoding methods vary among spatial epidemiology studies. Errors in the geocoding process and differential match rates may reduce study validity. We compared two geocoding methods using 8,157 Washington State addresses. The multi-stage geocoding method implemented by the state health department used a sequence of local and national reference files. The single-stage method used a single national reference file. For each address geocoded by both methods, we measured the distance between the locations assigned by each method. Area-level characteristics were collected from census data, and modeled as predictors of the discordance between geocoded address coordinates. Results The multi-stage method had a higher match rate than the single-stage method: 99% versus 95%. Of 7,686 addresses were geocoded by both methods, 96% were geocoded to the same census tract by both methods and 98% were geocoded to locations within 1 km of each other by the two methods. The distance between geocoded coordinates for the same address was higher in sparsely populated and low poverty areas, and counties with local reference files. Conclusion The multi-stage geocoding method had a higher match rate than the single-stage method. An examination of differences in the location assigned to the same address suggested that study results may be most sensitive to the choice of geocoding method in sparsely populated or low-poverty areas.

Staging in bipolar disorder: from theoretical framework to clinical utility.

Science.gov (United States)

Berk, Michael; Post, Robert; Ratheesh, Aswin; Gliddon, Emma; Singh, Ajeet; Vieta, Eduard; Carvalho, Andre F; Ashton, Melanie M; Berk, Lesley; Cotton, Susan M; McGorry, Patrick D; Fernandes, Brisa S; Yatham, Lakshmi N; Dodd, Seetal

2017-10-01

Illness staging is widely utilized in several medical disciplines to help predict course or prognosis, and optimize treatment. Staging models in psychiatry in general, and bipolar disorder in particular, depend on the premise that psychopathology moves along a predictable path: an at-risk or latency stage, a prodrome progressing to a first clinical threshold episode, and one or more recurrences with the potential to revert or progress to late or end-stage manifestations. The utility and validity of a staging model for bipolar disorder depend on its linking to clinical outcome, treatment response and neurobiological measures. These include progressive biochemical, neuroimaging and cognitive changes, and potentially stage-specific differences in response to pharmacological and psychosocial treatments. Mechanistically, staging models imply the presence of an active disease process that, if not remediated, can lead to neuroprogression, a more malignant disease course and functional deterioration. Biological elements thought to be operative in bipolar disorder include a genetic diathesis, physical and psychic trauma, epigenetic changes, altered neurogenesis and apoptosis, mitochondrial dysfunction, inflammation, and oxidative stress. Many available agents, such as lithium, have effects on these targets. Staging models also suggest the utility of stage-specific treatment approaches that may not only target symptom reduction, but also impede illness neuroprogression. These treatment approaches range from prevention for at-risk individuals, to early intervention strategies for prodromal and newly diagnosed individuals, complex combination therapy for rapidly recurrent illness, and palliative-type approaches for those at chronic, late stages of illness. There is hope that prompt initiation of potentially disease modifying therapies may preclude or attenuate the cognitive and structural changes seen in the later stages of bipolar disorder. The aims of this paper are to: a

Metabolomics Identifies Multiple Candidate Biomarkers to Diagnose and Stage Human African Trypanosomiasis.

Directory of Open Access Journals (Sweden)

Isabel M Vincent

2016-12-01

Full Text Available Treatment for human African trypanosomiasis is dependent on the species of trypanosome causing the disease and the stage of the disease (stage 1 defined by parasites being present in blood and lymphatics whilst for stage 2, parasites are found beyond the blood-brain barrier in the cerebrospinal fluid (CSF. Currently, staging relies upon detecting the very low number of parasites or elevated white blood cell numbers in CSF. Improved staging is desirable, as is the elimination of the need for lumbar puncture. Here we use metabolomics to probe samples of CSF, plasma and urine from 40 Angolan patients infected with Trypanosoma brucei gambiense, at different disease stages. Urine samples provided no robust markers indicative of infection or stage of infection due to inherent variability in urine concentrations. Biomarkers in CSF were able to distinguish patients at stage 1 or advanced stage 2 with absolute specificity. Eleven metabolites clearly distinguished the stage in most patients and two of these (neopterin and 5-hydroxytryptophan showed 100% specificity and sensitivity between our stage 1 and advanced stage 2 samples. Neopterin is an inflammatory biomarker previously shown in CSF of stage 2 but not stage 1 patients. 5-hydroxytryptophan is an important metabolite in the serotonin synthetic pathway, the key pathway in determining somnolence, thus offering a possible link to the eponymous symptoms of "sleeping sickness". Plasma also yielded several biomarkers clearly indicative of the presence (87% sensitivity and 95% specificity and stage of disease (92% sensitivity and 81% specificity. A logistic regression model including these metabolites showed clear separation of patients being either at stage 1 or advanced stage 2 or indeed diseased (both stages versus control.

Single-Stage Treatment of Osteomyelitis for Digital Salvage by Using an Antibiotic-Eluting, Methylmethacrylate Joint-Spanning Spacer.

Science.gov (United States)

Aimé, Victoria L; Kidwell, John T; Webb, Leland H

2017-06-01

Osteomyelitis of the digit is a challenging problem that can result in amputation. We describe 13 cases of osteomyelitis involving bones of the hand managed with a novel technique. We reviewed records of 12 patients (13 digits) who had joint-spanning, antibiotic-eluting (tobramycin or vancomycin), methylmethacrylate spacers placed as definitive, single-stage treatment for digital osteomyelitis. The primary outcome was digit salvage. Secondary outcomes were infection eradication (no recurrence at 3 months) and spacer removal. Patients were followed up until the infection resolved (ie, no cutaneous signs of infection, including pain, erythema, or swelling). At a mean of 24 months, 10 of 13 infections had successful one-stage treatment. One patient required a second operation to revise a soft tissue flap but the spacer remained in place. Two spacers were removed because of malalignment. An antibiotic-eluting methylmethacrylate spacer is an innovative treatment for digital osteomyelitis. In 12 consecutive patients (13 digits), we successfully salvaged the digit. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Comparison of two-stage thermophilic (68 degrees C/55 degrees C) anaerobic digestion with one-stage thermophilic (55 degrees C) digestion of cattle manure

DEFF Research Database (Denmark)

Nielsen, H.B.; Mladenovska, Zuzana; Westermann, Peter

2004-01-01

A two-stage 68degreesC/55degreesC anaerobic degradation process for treatment of cattle manure was studied. In batch experiments, an increase of the specific methane yield, ranging from 24% to 56%, was obtained when cattle manure and its fractions (fibers and liquid) were pretreated at 68degrees......, was compared with a conventional single-stage reactor running at 55degreesC with 15-days HRT. When an organic loading of 3 g volatile solids (VS) per liter per day was applied, the two-stage setup had a 6% to 8% higher specific methane yield and a 9% more effective VS-removal than the conventional single......-stage reactor. The 68degreesC reactor generated 7% to 9% of the total amount of methane of the two-stage system and maintained a volatile fatty acids (VFA) concentration of 4.0 to 4.4 g acetate per liter. Population size and activity of aceticlastic methanogens, syntrophic bacteria, and hydrolytic...

Critical Thinking & Lifelong Learning: An ADKAR Model-Based Framework for Managing a Change in Thinking & English Language Learning Styles at the Secondary Stage

Science.gov (United States)

Abdallah, Mahmoud M. S.; Mohammad, Marwa M. M.

2016-01-01

The general secondary stage in Egypt is a vital educational phase since it plays an essential role in developing students' thinking and learning styles to prepare them for life in general and higher education in particular. Accordingly, it has become urgent and persistent to develop secondary-stage students' critical thinking styles while…

Study of Stage-wise Pressure Pulsation in an Electric Submersible Pump under Variable Frequency Operation at Shut-off Condition

Science.gov (United States)

Dhanasekaran, A.; Kumaraswamy, S.

2018-01-01

Pressure pulsation causes vibration in the Electric Submersible Pump (ESP) and affects the life and performance of its system. ESP systems are installed at depths ranging from a few meters to several hundred meters. Unlike pumps used on the surface, once they are installed they become inaccessible for maintenance or for any kind of diagnostic measurement that might be taken directly on them. Therefore a detailed knowledge of mean and fluctuating pressures is required to achieve an optimal pressure distribution inside the ESP. This paper presents the results of an experimental investigation of the stage-wise pulsating pressure in ESP at shut-off condition at different speeds. Experiments were conducted on a pump having five stages. A variable frequency drive was used to operate the pump at five different speeds. Piezoresistive transducers were mounted at each stage of ESP to capture the unsteady pressure signals. Fast Fourier Transformation was carried out on the pressure signals to convert into frequency domain and the spectra of pressure pulsation signals were analyzed. The obtained results indicated the existence of fundamental frequency corresponding to the speed of rotation times the number of impeller blades and of the whole series of harmonics of higher frequencies.

Two-Stage Series-Resonant Inverter

Science.gov (United States)

Stuart, Thomas A.

1994-01-01

Two-stage inverter includes variable-frequency, voltage-regulating first stage and fixed-frequency second stage. Lightweight circuit provides regulated power and is invulnerable to output short circuits. Does not require large capacitor across ac bus, like parallel resonant designs. Particularly suitable for use in ac-power-distribution system of aircraft.

A six-degree-of-freedom magnetic levitation fine stage for a high-precision and high-acceleration dual-servo stage

International Nuclear Information System (INIS)

Kim, MyeongHyeon; Jeong, Jae-heon; Gweon, DaeGab; Kim, HyoYoung

2015-01-01

This paper presents a novel six-degree-of-freedom magnetic levitation fine stage for a dual-servo stage. The proposed fine stage is levitated and actuated, using a voice coil motor actuator with a Halbach magnet array. For a dual-servo stage, fine stage performance is deeply intertwined with coarse stage performance. Because the fine stage is installed over the coarse stage, the overall size of the fine stage can be limited by the moving plate of the coarse stage. Therefore, magnetic flux modeling and optimization are performed to manufacture optimal fine stages. To control the fine stage, actuator kinetics and sensor kinematics are proposed. Homing control is implemented by using linear variable differential transformers, whereas fine control is implemented by capacitance sensors and laser interferometers. Finally, experimental results of in-position stability, moving range, and repeatability are presented. (paper)

Problem solving stages in the five square problem.

Science.gov (United States)

Fedor, Anna; Szathmáry, Eörs; Öllinger, Michael

2015-01-01

According to the restructuring hypothesis, insight problem solving typically progresses through consecutive stages of search, impasse, insight, and search again for someone, who solves the task. The order of these stages was determined through self-reports of problem solvers and has never been verified behaviorally. We asked whether individual analysis of problem solving attempts of participants revealed the same order of problem solving stages as defined by the theory and whether their subjective feelings corresponded to the problem solving stages they were in. Our participants tried to solve the Five-Square problem in an online task, while we recorded the time and trajectory of their stick movements. After the task they were asked about their feelings related to insight and some of them also had the possibility of reporting impasse while working on the task. We found that the majority of participants did not follow the classic four-stage model of insight, but had more complex sequences of problem solving stages, with search and impasse recurring several times. This means that the classic four-stage model is not sufficient to describe variability on the individual level. We revised the classic model and we provide a new model that can generate all sequences found. Solvers reported insight more often than non-solvers and non-solvers reported impasse more often than solvers, as expected; but participants did not report impasse more often during behaviorally defined impasse stages than during other stages. This shows that impasse reports might be unreliable indicators of impasse. Our study highlights the importance of individual analysis of problem solving behavior to verify insight theory.

Problem solving stages in the five square problem

Directory of Open Access Journals (Sweden)

Anna eFedor

2015-08-01

Full Text Available According to the restructuring hypothesis, insight problem solving typically progresses through consecutive stages of search, impasse, insight and search again for someone, who solves the task. The order of these stages was determined through self-reports of problem solvers and has never been verified behaviourally. We asked whether individual analysis of problem solving attempts of participants revealed the same order of problem solving stages as defined by the theory and whether their subjective feelings corresponded to the problem solving stages they were in. 101 participants tried to solve the Five-Square problem in an online task, while we recorded the time and trajectory of their stick movements. After the task they were asked about their feelings related to insight and 67 of them also had the possibility of reporting impasse while working on the task. We have found that 49% (19 out of 39 of the solvers and 13% (8 out of 62 of the non-solvers followed the classic four-stage model of insight. The rest of the participants had more complex sequences of problem solving stages, with search and impasse recurring several times. This means that the classic four-stage model must be extended to explain variability on the individual level. We provide a model that can generate all sequences found. Solvers reported insight more often than non-solvers and non-solvers reported impasse more often than solvers, as expected; but participants did not report impasse more often during behaviourally defined impasse stages than during other stages. This shows that impasse reports might be unreliable indicators of impasse. Our study highlights the importance of individual analysis of problem solving behaviour to verify insight theory.

Ovarian Cancer Stage II

Science.gov (United States)

... peritoneal cancer; the first panel (stage IIA) shows cancer inside both ovaries that has spread to the uterus and fallopian tube. The second panel (stage IIB) shows cancer inside both ovaries that has spread to the colon. The third ...

Experiments for Multi-Stage Processes

DEFF Research Database (Denmark)

Tyssedal, John; Kulahci, Murat

2015-01-01

Multi-stage processes are very common in both process and manufacturing industries. In this article we present a methodology for designing experiments for multi-stage processes. Typically in these situations the design is expected to involve many factors from different stages. To minimize...... the required number of experimental runs, we suggest using mirror image pairs of experiments at each stage following the first. As the design criterion, we consider their projectivity and mainly focus on projectivity 3 designs. We provide the methodology for generating these designs for processes with any...

Development of an integrative algorithm for the treatment of various stages of full-thickness burns of the first commissure of the hand.

Science.gov (United States)

Yuste, Valentin; Delgado, Julio; Agullo, Alberto; Sampietro, Jose Mauel

2017-06-01

Burns of the first commissure of the hand can evolve into an adduction contracture of the thumb. We decided to conduct a review of the existing literature on the treatment of full-thickness burns of the first commissure in order to develop a treatment algorithm that integrates the various currently available procedures. A search of the existing literature was conducted, focusing on the treatment of a burn of the first commissure in its chronic and acute phases. A total of 29 relevant articles were selected; 24 focused exclusively on the chronic contracture stage, while 3 focused exclusively on the acute burn stage, and 2 articles studied both stages. A therapeutic algorithm for full-thickness burns of the first commissure of the hand was developed. With this algorithm we sought to relate each degree and stage of the burn with a treatment. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

An idealized model for tree-grass coexistence in savannas : The role of life stage structure and fire disturbances

NARCIS (Netherlands)

Baudena, Mara|info:eu-repo/dai/nl/340303867; D'Andrea, Fabio; Provenzale, A.

2010-01-01

1. We discuss a simple implicit-space model for the competition of trees and grasses in an idealized savanna environment. The model represents patch occupancy dynamics within the habitat and introduces life stage structure in the tree population, namely adults and seedlings. A tree can be

The IASLC Lung Cancer Staging Project

DEFF Research Database (Denmark)

Chansky, Kari; Detterbeck, Frank C; Nicholson, Andrew G

2017-01-01

INTRODUCTION: Revisions to the TNM stage classifications for lung cancer, informed by the international database (N = 94,708) of the International Association for the Study of Lung Cancer (IASLC) Staging and Prognostic Factors Committee, need external validation. The objective was to externally...... demonstrated consistent ability to discriminate TNM categories and stage groups for clinical and pathologic stage. CONCLUSIONS: The IASLC revisions made for the eighth edition of lung cancer staging are validated by this analysis of the NCDB database by the ordering, statistical differences, and homogeneity...... validate the revisions by using the National Cancer Data Base (NCDB) of the American College of Surgeons. METHODS: Cases presenting from 2000 through 2012 were drawn from the NCDB and reclassified according to the eighth edition stage classification. Clinically and pathologically staged subsets of NSCLC...

Probability analysis of MCO over-pressurization during staging

International Nuclear Information System (INIS)

Pajunen, A.L.

1997-01-01

The purpose of this calculation is to determine the probability of Multi-Canister Overpacks (MCOs) over-pressurizing during staging at the Canister Storage Building (CSB). Pressurization of an MCO during staging is dependent upon changes to the MCO gas temperature and the build-up of reaction products during the staging period. These effects are predominantly limited by the amount of water that remains in the MCO following cold vacuum drying that is available for reaction during staging conditions. Because of the potential for increased pressure within an MCO, provisions for a filtered pressure relief valve and rupture disk have been incorporated into the MCO design. This calculation provides an estimate of the frequency that an MCO will contain enough water to pressurize beyond the limits of these design features. The results of this calculation will be used in support of further safety analyses and operational planning efforts. Under the bounding steady state CSB condition assumed for this analysis, an MCO must contain less than 1.6 kg (3.7 lbm) of water available for reaction to preclude actuation of the pressure relief valve at 100 psid. To preclude actuation of the MCO rupture disk at 150 psid, an MCO must contain less than 2.5 kg (5.5 lbm) of water available for reaction. These limits are based on the assumption that hydrogen generated by uranium-water reactions is the sole source of gas produced within the MCO and that hydrates in fuel particulate are the primary source of water available for reactions during staging conditions. The results of this analysis conclude that the probability of the hydrate water content of an MCO exceeding 1.6 kg is 0.08 and the probability that it will exceed 2.5 kg is 0.01. This implies that approximately 32 of 400 staged MCOs may experience pressurization to the point where the pressure relief valve actuates. In the event that an MCO pressure relief valve fails to open, the probability is 1 in 100 that the MCO would experience

Development costs for a nuclear electric propulsion stage.

Science.gov (United States)

Mondt, J. F.; Prickett, W. Z.

1973-01-01

Development costs are presented for an unmanned nuclear electric propulsion (NEP) stage based upon a liquid metal cooled, in-core thermionic reactor. A total of 120 kWe are delivered to the thrust subsystem which employs mercury ion engines for electric propulsion. This study represents the most recent cost evaluation of the development of a reactor power system for a wide range of nuclear space power applications. These include geocentric, and outer planet and other deep space missions. The development program is described for the total NEP stage, based upon specific development programs for key NEP stage components and subsystems.

Impact of chronic kidney disease stage on lower-extremity arthroplasty.

Science.gov (United States)

Deegan, Brian F; Richard, Raveesh D; Bowen, Thomas R; Perkins, Robert M; Graham, Jove H; Foltzer, Michael A

2014-07-01

End-stage renal disease and dialysis is commonly associated with poor outcomes after joint replacement surgery. The goal of this study was to evaluate postoperative complications in patients with less advanced chronic kidney disease undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). Patients who underwent THA or TKA between 2004 and 2011 with stage 1, 2, or 3 chronic kidney disease were retrospectively reviewed via an electronic medical record. The authors compared 377 patients who had stage 1 to 2 chronic kidney disease with 402 patients who had stage 3 chronic kidney disease. No significant differences in 90-day readmission or revision rates were found between the stage 1 to 2 and stage 3 patient groups. For patients with stage 3 chronic kidney disease, the overall mortality rate was greater than that in patients with stage 1 to 2 chronic kidney disease. However, when adjusted for comorbid disease, no significant increases were seen in joint infection, readmission, or early revision between patients with stage 1 to 2 chronic kidney disease vs patients with stage 3 chronic kidney disease. The overall incidence of infection was high (3.5%) but far less than reported for patients with end-stage renal disease, dialysis, and kidney transplant. In conclusion, patients with stage 1, 2, or 3 chronic kidney disease may have a higher than expected rate of prosthetic joint infection (3.5%) after total joint arthroplasty. Patients with stage 3 chronic kidney disease are at higher risk for postoperative mortality compared with those with lesser stages of kidney disease. Copyright 2014, SLACK Incorporated.

Social Development Training Project. Stage I and Stage II. [The Granville Project].

Science.gov (United States)

Riches, Vivienne C., Ed.

The book presents a training program developed at the Granville Work Preparation Centre in Australia, to teach mildly retarded adolescents basic social skills and competencies. The program is divided into two stages, with a total of 17 different skill areas. Stage 1 covers self-awareness, social/interpersonal skills, relaxation and behavioral self…

Hepatic imaging in stage IV-S neuroblastoma

International Nuclear Information System (INIS)

Franken, E.A. Jr.; Smith, W.L.; Iowa Univ., Iowa City; Cohen, M.D.; Kisker, C.T.; Platz, C.E.

1986-01-01

Stage IV-S neuroblastoma describes a group of infants with tumor spread limited to liver, skin, or bone marrow. Such patients, who constitute about 25% of affected infants with neuroblastoma, may expect spontaneous tumor remission. We report 18 infants with Stage IV-S neuroblastoma, 83% of whom had liver involvement. Imaging investigations included Technetium 99m sulfur colloid scan, ultrasound, and CT. Two patterns of liver metastasis were noted: ill-defined nodules or diffuse tumor throughout the liver. Distinction of normal and abnormal liver with diffuse type metastasis could be quite difficult, particularly with liver scans. We conclude that patients with Stage IV-S neuroblastoma have ultrasound or CT examination as an initial workup, with nuclear medicine scans reserved for followup studies. (orig.)

Evolutionary Stages of e-Tailors and Retailers: Firm Value Determinants Model

OpenAIRE