WorldWideScience

Sample records for mds discharge record

  1. The Mice Drawer System (MDS experiment and the space endurance record-breaking mice.

    Directory of Open Access Journals (Sweden)

    Ranieri Cancedda

    Full Text Available The Italian Space Agency, in line with its scientific strategies and the National Utilization Plan for the International Space Station (ISS, contracted Thales Alenia Space Italia to design and build a spaceflight payload for rodent research on ISS: the Mice Drawer System (MDS. The payload, to be integrated inside the Space Shuttle middeck during transportation and inside the Express Rack in the ISS during experiment execution, was designed to function autonomously for more than 3 months and to involve crew only for maintenance activities. In its first mission, three wild type (Wt and three transgenic male mice over-expressing pleiotrophin under the control of a bone-specific promoter (PTN-Tg were housed in the MDS. At the time of launch, animals were 2-months old. MDS reached the ISS on board of Shuttle Discovery Flight 17A/STS-128 on August 28(th, 2009. MDS returned to Earth on November 27(th, 2009 with Shuttle Atlantis Flight ULF3/STS-129 after 91 days, performing the longest permanence of mice in space. Unfortunately, during the MDS mission, one PTN-Tg and two Wt mice died due to health status or payload-related reasons. The remaining mice showed a normal behavior throughout the experiment and appeared in excellent health conditions at landing. During the experiment, the mice health conditions and their water and food consumption were daily checked. Upon landing mice were sacrificed, blood parameters measured and tissues dissected for subsequent analysis. To obtain as much information as possible on microgravity-induced tissue modifications, we organized a Tissue Sharing Program: 20 research groups from 6 countries participated. In order to distinguish between possible effects of the MDS housing conditions and effects due to the near-zero gravity environment, a ground replica of the flight experiment was performed at the University of Genova. Control tissues were collected also from mice maintained on Earth in standard vivarium cages.

  2. The Mice Drawer System (MDS) experiment and the space endurance record-breaking mice.

    Science.gov (United States)

    Cancedda, Ranieri; Liu, Yi; Ruggiu, Alessandra; Tavella, Sara; Biticchi, Roberta; Santucci, Daniela; Schwartz, Silvia; Ciparelli, Paolo; Falcetti, Giancarlo; Tenconi, Chiara; Cotronei, Vittorio; Pignataro, Salvatore

    2012-01-01

    The Italian Space Agency, in line with its scientific strategies and the National Utilization Plan for the International Space Station (ISS), contracted Thales Alenia Space Italia to design and build a spaceflight payload for rodent research on ISS: the Mice Drawer System (MDS). The payload, to be integrated inside the Space Shuttle middeck during transportation and inside the Express Rack in the ISS during experiment execution, was designed to function autonomously for more than 3 months and to involve crew only for maintenance activities. In its first mission, three wild type (Wt) and three transgenic male mice over-expressing pleiotrophin under the control of a bone-specific promoter (PTN-Tg) were housed in the MDS. At the time of launch, animals were 2-months old. MDS reached the ISS on board of Shuttle Discovery Flight 17A/STS-128 on August 28(th), 2009. MDS returned to Earth on November 27(th), 2009 with Shuttle Atlantis Flight ULF3/STS-129 after 91 days, performing the longest permanence of mice in space. Unfortunately, during the MDS mission, one PTN-Tg and two Wt mice died due to health status or payload-related reasons. The remaining mice showed a normal behavior throughout the experiment and appeared in excellent health conditions at landing. During the experiment, the mice health conditions and their water and food consumption were daily checked. Upon landing mice were sacrificed, blood parameters measured and tissues dissected for subsequent analysis. To obtain as much information as possible on microgravity-induced tissue modifications, we organized a Tissue Sharing Program: 20 research groups from 6 countries participated. In order to distinguish between possible effects of the MDS housing conditions and effects due to the near-zero gravity environment, a ground replica of the flight experiment was performed at the University of Genova. Control tissues were collected also from mice maintained on Earth in standard vivarium cages.

  3. Deriving Global Discharge Records from SWOT Observations

    Science.gov (United States)

    Pan, M.; Fisher, C. K.; Wood, E. F.

    2017-12-01

    River flows are poorly monitored in many regions of the world, hindering our ability to accurately estimate water global water usage, and thus estimate global water and energy budgets or the variability in the global water cycle. Recent developments in satellite remote sensing, such as water surface elevations from radar altimetry or surface water extents from visible/infrared imagery, aim to fill this void; however, the streamflow estimates derived from these are inherently intermittent in both space and time. There is then a need for new methods that are able to derive spatially and temporally continuous records of discharge from the many available data sources. One particular application of this will be the Surface Water and Ocean Topography (SWOT) mission, which is designed to provide global observations of water surface elevation and slope from which river discharge can be estimated. Within the 21-day repeat cycle, a river reach will be observed 2-4 times on average. Due to the relationship between the basin orientation and the orbit, these observations are not evenly distributed in time or space. In this study, we investigate how SWOT will observe global river basins and how the temporal and spatial sampling impacts our ability to reconstruct discharge records.River flows can be estimated throughout a basin by assimilating SWOT observations using the Inverse Streamflow Routing (ISR) model of Pan and Wood [2013]. This method is applied to 32 global basins with different geometries and crossing patterns for the future orbit, assimilating theoretical SWOT-retrieved "gauges". Results show that the model is able to reconstruct basin-wide discharge from SWOT observations alone; however, the performance varies significantly across basins and is driven by the orientation, flow distance, and travel time in each, as well as the sensitivity of the reconstruction method to errors in the satellite retrieval. These properties are combined to estimate the "observability" of

  4. Surgical discharge summaries: improving the record.

    Science.gov (United States)

    Adams, D C; Bristol, J B; Poskitt, K R

    1993-03-01

    The problem area of communication between hospital and general practitioners may potentially be improved by the advent of new information technology. The introduction of a regional computer database for general surgery allows the rapid automated production of discharge summaries and has provided us with the opportunity for auditing the quality of old and new styles of discharge communication. A total of 118 general practitioners were sent a postal questionnaire to establish their views on the relative importance of various aspects of patient information and management after discharge. A high response rate (97%) indicated the interest of general practitioners in this topic. The majority (73%) believed that summaries should be delayed no more than 3 days. The structured and shortened new format was preferred to the older style of discharge summary. The older format rarely arrived within an appropriate time and its content was often felt to be either inadequate (35%) or excessive (7%) compared with the new format (8% and 1%, respectively). The diagnosis, information given to the patient, clinic date, list of medications and investigations were considered the more important details in the summary. Improvements in the discharge information were suggested and have subsequently been incorporated in our discharge policy. The use of new information technology, intended to facilitate clinical audit, has improved our ability to generate prompt, well-structured discharge summaries which are accepted by the general practitioners.

  5. MDS MIC Catalog Inputs

    Science.gov (United States)

    Johnson-Throop, Kathy A.; Vowell, C. W.; Smith, Byron; Darcy, Jeannette

    2006-01-01

    This viewgraph presentation reviews the inputs to the MDS Medical Information Communique (MIC) catalog. The purpose of the group is to provide input for updating the MDS MIC Catalog and to request that MMOP assign Action Item to other working groups and FSs to support the MITWG Process for developing MIC-DDs.

  6. Pathophysiology of MDS: genomic aberrations.

    Science.gov (United States)

    Ichikawa, Motoshi

    2016-01-01

    Myelodysplastic syndromes (MDS) are characterized by clonal proliferation of hematopoietic stem/progenitor cells and their apoptosis, and show a propensity to progress to acute myelogenous leukemia (AML). Although MDS are recognized as neoplastic diseases caused by genomic aberrations of hematopoietic cells, the details of the genetic abnormalities underlying disease development have not as yet been fully elucidated due to difficulties in analyzing chromosomal abnormalities. Recent advances in comprehensive analyses of disease genomes including whole-genome sequencing technologies have revealed the genomic abnormalities in MDS. Surprisingly, gene mutations were found in approximately 80-90% of cases with MDS, and the novel mutations discovered with these technologies included previously unknown, MDS-specific, mutations such as those of the genes in the RNA-splicing machinery. It is anticipated that these recent studies will shed new light on the pathophysiology of MDS due to genomic aberrations.

  7. Strongly-MDS convolutional codes

    NARCIS (Netherlands)

    Gluesing-Luerssen, H; Rosenthal, J; Smarandache, R

    Maximum-distance separable (MDS) convolutional codes have the property that their free distance is maximal among all codes of the same rate and the same degree. In this paper, a class of MDS convolutional codes is introduced whose column distances reach the generalized Singleton bound at the

  8. Using the Electronic Medical Record to Enhance Physician-Nurse Communication Regarding Patients' Discharge Status.

    Science.gov (United States)

    Driscoll, Molly; Gurka, David

    2015-01-01

    The fast-paced environment of hospitals contributes to communication failures between health care providers while impacting patient care and patient flow. An effective mechanism for sharing patients' discharge information with health care team members is required to improve patient throughput. The communication of a patient's discharge plan was identified as crucial in alleviating patient flow delays at a tertiary care, academic medical center. By identifying the patients who were expected to be discharged the following day, the health care team could initiate discharge preparations in advance to improve patient care and patient flow. The patients' electronic medical record served to convey dynamic information regarding the patients' discharge status to the health care team via conditional discharge orders. Two neurosciences units piloted a conditional discharge order initiative. Conditional discharge orders were designed in the electronic medical record so that the conditions for discharge were listed in a dropdown menu. The health care team was trained on the conditional discharge order protocol, including when to write them, how to find them in the patients' electronic medical record, and what actions should be prompted by these orders. On average, 24% of the patients discharged had conditional discharge orders written the day before discharge. The average discharge time for patients with conditional discharge orders decreased by 83 minutes (0.06 day) from baseline. Qualitatively, the health care team reported improved workflows with conditional orders. The conditional discharge orders allowed physicians to communicate pending discharges electronically to the multidisciplinary team. The initiative positively impacted patient discharge times and workflows.

  9. Estuarine abandoned channel sedimentation rates record peak fluvial discharge magnitudes

    Science.gov (United States)

    Gray, A. B.; Pasternack, G. B.; Watson, E. B.

    2018-04-01

    Fluvial sediment deposits can provide useful records of integrated watershed expressions including flood event magnitudes. However, floodplain and estuarine sediment deposits evolve through the interaction of watershed/marine sediment supply and transport characteristics with the local depositional environment. Thus extraction of watershed scale signals depends upon accounting for local scale effects on sediment deposition rates and character. This study presents an examination of the balance of fluvial sediment dynamics and local scale hydro-geomorphic controls on alluviation of an abandoned channel in the Salinas River Lagoon, CA. A set of three sediment cores contained discrete flood deposits that corresponded to the largest flood events over the period of accretion from 1969 to 2007. Sedimentation rates scaled with peak flood discharge and event scale sediment flux, but were not influenced by longer scale hydro-meteorological activities such as annual precipitation and water yield. Furthermore, the particle size distributions of flood deposits showed no relationship to event magnitudes. Both the responsiveness of sedimentation and unresponsiveness of particle size distributions to hydro-sedimentological event magnitudes appear to be controlled by aspects of local geomorphology that influence the connectivity of the abandoned channel to the Salinas River mainstem. Well-developed upstream plug bar formation precluded the entrainment of coarser bedload into the abandoned channel, while Salinas River mouth conditions (open/closed) in conjunction with tidal and storm surge conditions may play a role in influencing the delivery of coarser suspended load fractions. Channel adjacent sediment deposition can be valuable records of hydro-meteorological and sedimentological regimes, but local depositional settings may dominate the character of short term (interdecadal) signatures.

  10. 33 CFR 159.315 - Sewage and graywater discharge record book.

    Science.gov (United States)

    2010-07-01

    ... record book. 159.315 Section 159.315 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... by Cruise Vessel Operations § 159.315 Sewage and graywater discharge record book. (a) While operating... and Graywater Discharge Record Book with the vessel's name and official number listed on the front...

  11. MDS Quality Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of the quality measures displayed on Nursing Home Compare, excluding Measures of Rehospitalization, Emergency Room Visit, and Community Discharge. Each row...

  12. MDS 3.0 Frequency Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MDS 3.0 Frequency Report summarizes information for active residents currently in nursing homes. The source of these counts is the residents MDS assessment...

  13. New MDS or near MDS self-dual codes over finite fields

    OpenAIRE

    Tong, Hongxi; Wang, Xiaoqing

    2016-01-01

    The study of MDS self-dual codes has attracted lots of attention in recent years. There are many papers on determining existence of $q-$ary MDS self-dual codes for various lengths. There are not existence of $q-$ary MDS self-dual codes of some lengths, even these lengths $< q$. We generalize MDS Euclidean self-dual codes to near MDS Euclidean self-dual codes and near MDS isodual codes. And we obtain many new near MDS isodual codes from extended negacyclic duadic codes and we obtain many new M...

  14. Pediatric MDS: GATA screen the germline.

    Science.gov (United States)

    Stieglitz, Elliot; Loh, Mignon L

    2016-03-17

    In this issue of Blood, Wlodarski and colleagues demonstrate that as many as 72% of adolescents diagnosed with myelodysplastic syndrome (MDS) and monosomy 7 harbor germline mutations in GATA2. Although pediatric MDS is a very rare diagnosis, occurring in 0.8 to 4 cases per million, Wlodarski et al screened >600 cases of primary or secondary MDS in children and adolescents who were enrolled in the European Working Group on MDS consortium over a period of 15 years. The overall frequency of germline GATA2 mutations in children with primary MDS was 7%, and 15% in those presenting with advanced disease. Notably, mutations in GATA2 were absent in patients with therapy-related MDS or acquired aplastic anemia.

  15. MDS system increases drilling safety and efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Chevallier, J.; Turner, L. (Sedco Forex, Paris (FR))

    1989-09-01

    There's a great deal of data recorded during drilling operations on rigs these days, but it is seldom well utilized. The operator's company person relies upon mud loggers for collecting and recording most information. The methods used to process and display this information are often inadequate for those who need it the most the driller and toolpusher. Drilling contractor personnel usually have only rudimentary displays of drilling parameters, and practically no serious method of analysis except for daily paper reports. These are cumbersome to use and provide only incomplete data, after the fact. The MDS system, presented in this article, is a new information and alarm network, which rectifies this situation by bringing to the rig, for the first time, the latest in sensor and computer technologies. This system acquires key drilling data on the rig floor, pump room, and return line, and displays it in a clear graphical format to both the driller and the toolpusher in real time. It also provides the toolpusher with a workstation for easy access to the same information for evaluation and planning of the drilling program.

  16. Multivariate regression methods for estimating velocity of ictal discharges from human microelectrode recordings

    Science.gov (United States)

    Liou, Jyun-you; Smith, Elliot H.; Bateman, Lisa M.; McKhann, Guy M., II; Goodman, Robert R.; Greger, Bradley; Davis, Tyler S.; Kellis, Spencer S.; House, Paul A.; Schevon, Catherine A.

    2017-08-01

    Objective. Epileptiform discharges, an electrophysiological hallmark of seizures, can propagate across cortical tissue in a manner similar to traveling waves. Recent work has focused attention on the origination and propagation patterns of these discharges, yielding important clues to their source location and mechanism of travel. However, systematic studies of methods for measuring propagation are lacking. Approach. We analyzed epileptiform discharges in microelectrode array recordings of human seizures. The array records multiunit activity and local field potentials at 400 micron spatial resolution, from a small cortical site free of obstructions. We evaluated several computationally efficient statistical methods for calculating traveling wave velocity, benchmarking them to analyses of associated neuronal burst firing. Main results. Over 90% of discharges met statistical criteria for propagation across the sampled cortical territory. Detection rate, direction and speed estimates derived from a multiunit estimator were compared to four field potential-based estimators: negative peak, maximum descent, high gamma power, and cross-correlation. Interestingly, the methods that were computationally simplest and most efficient (negative peak and maximal descent) offer non-inferior results in predicting neuronal traveling wave velocities compared to the other two, more complex methods. Moreover, the negative peak and maximal descent methods proved to be more robust against reduced spatial sampling challenges. Using least absolute deviation in place of least squares error minimized the impact of outliers, and reduced the discrepancies between local field potential-based and multiunit estimators. Significance. Our findings suggest that ictal epileptiform discharges typically take the form of exceptionally strong, rapidly traveling waves, with propagation detectable across millimeter distances. The sequential activation of neurons in space can be inferred from clinically

  17. Long Term Care Minimum Data Set (MDS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Long-Term Care Minimum Data Set (MDS) is a standardized, primary screening and assessment tool of health status that forms the foundation of the comprehensive...

  18. Proposed minimal diagnostic criteria for myelodysplastic syndromes (MDS) and potential pre-MDS conditions.

    Science.gov (United States)

    Valent, Peter; Orazi, Attilio; Steensma, David P; Ebert, Benjamin L; Haase, Detlef; Malcovati, Luca; van de Loosdrecht, Arjan A; Haferlach, Torsten; Westers, Theresia M; Wells, Denise A; Giagounidis, Aristoteles; Loken, Michael; Orfao, Alberto; Lübbert, Michael; Ganser, Arnold; Hofmann, Wolf-Karsten; Ogata, Kiyoyuki; Schanz, Julie; Béné, Marie C; Hoermann, Gregor; Sperr, Wolfgang R; Sotlar, Karl; Bettelheim, Peter; Stauder, Reinhard; Pfeilstöcker, Michael; Horny, Hans-Peter; Germing, Ulrich; Greenberg, Peter; Bennett, John M

    2017-09-26

    Myelodysplastic syndromes (MDS) comprise a heterogeneous group of myeloid neoplasms characterized by peripheral cytopenia, dysplasia, and a variable clinical course with about 30% risk to transform to secondary acute myeloid leukemia (AML). In the past 15 years, diagnostic evaluations, prognostication, and treatment of MDS have improved substantially. However, with the discovery of molecular markers and advent of novel targeted therapies, new challenges have emerged in the complex field of MDS. For example, MDS-related molecular lesions may be detectable in healthy individuals and increase in prevalence with age. Other patients exhibit persistent cytopenia of unknown etiology without dysplasia. Although these conditions are potential pre-phases of MDS they may also transform into other bone marrow neoplasms. Recently identified molecular, cytogenetic, and flow-based parameters may add in the delineation and prognostication of these conditions. However, no generally accepted integrated classification and no related criteria are as yet available. In an attempt to address this challenge, an international consensus group discussed these issues in a working conference in July 2016. The outcomes of this conference are summarized in the present article which includes criteria and a proposal for the classification of pre-MDS conditions as well as updated minimal diagnostic criteria of MDS. Moreover, we propose diagnostic standards to delineate between ´normal´, pre-MDS, and MDS. These standards and criteria should facilitate diagnostic and prognostic evaluations in clinical studies as well as in clinical practice.

  19. Hypotéza o MDS kódech

    OpenAIRE

    Kesely, Michal

    2010-01-01

    In this thesis, we study some properties of MDS codes and we mainly focus on the MDS codes conjecture. In the first chapter we define MDS codes, show some examples and basic properties of MDS codes, for example a link between MDS codes and Latin squares or rectangles. Afterwards we state the MDS codes conjecture and prove it in several cases. In the third chapter we can observe the relationship between MDS codes and narcs in projective geometries. Finally we present those known cases, for whi...

  20. Automated detection of follow-up appointments using text mining of discharge records.

    Science.gov (United States)

    Ruud, Kari L; Johnson, Matthew G; Liesinger, Juliette T; Grafft, Carrie A; Naessens, James M

    2010-06-01

    To determine whether text mining can accurately detect specific follow-up appointment criteria in free-text hospital discharge records. Cross-sectional study. Mayo Clinic Rochester hospitals. Inpatients discharged from general medicine services in 2006 (n = 6481). Textual hospital dismissal summaries were manually reviewed to determine whether the records contained specific follow-up appointment arrangement elements: date, time and either physician or location for an appointment. The data set was evaluated for the same criteria using SAS Text Miner software. The two assessments were compared to determine the accuracy of text mining for detecting records containing follow-up appointment arrangements. Agreement of text-mined appointment findings with gold standard (manual abstraction) including sensitivity, specificity, positive predictive and negative predictive values (PPV and NPV). About 55.2% (3576) of discharge records contained all criteria for follow-up appointment arrangements according to the manual review, 3.2% (113) of which were missed through text mining. Text mining incorrectly identified 3.7% (107) follow-up appointments that were not considered valid through manual review. Therefore, the text mining analysis concurred with the manual review in 96.6% of the appointment findings. Overall sensitivity and specificity were 96.8 and 96.3%, respectively; and PPV and NPV were 97.0 and 96.1%, respectively. of individual appointment criteria resulted in accuracy rates of 93.5% for date, 97.4% for time, 97.5% for physician and 82.9% for location. Text mining of unstructured hospital dismissal summaries can accurately detect documentation of follow-up appointment arrangement elements, thus saving considerable resources for performance assessment and quality-related research.

  1. Iron overload in myelodysplastic syndromes (MDS).

    Science.gov (United States)

    Gattermann, Norbert

    2018-01-01

    Iron overload (IOL) starts to develop in MDS patients before they become transfusion-dependent because ineffective erythropoiesis suppresses hepcidin production in the liver and thus leads to unrestrained intestinal iron uptake. However, the most important cause of iron overload in MDS is chronic transfusion therapy. While transfusion dependency by itself is a negative prognostic factor reflecting poor bone marrow function, the ensuing transfusional iron overload has an additional dose-dependent negative impact on the survival of patients with lower risk MDS. Cardiac dysfunction appears to be important in this context, as a consequence of chronic anemia, age-related cardiac comorbidity, and iron overload. Another potential problem is iron-related endothelial dysfunction. There is some evidence that with increasing age, high circulating iron levels worsen the atherosclerotic phenotype. Transfusional IOL also appears to aggravate bone marrow failure in MDS, through unfavorable effects on mesenchymal stromal cells as well a hematopoietic cells, particularly erythroid precursors. Patient series and clinical trials have shown that the iron chelators deferoxamine and deferasirox can improve hematopoiesis in a minority of transfusion-dependent patients. Analyses of registry data suggest that iron chelation provides a survival benefit for patients with MDS, but data from a prospective randomized clinical trial are still lacking.

  2. [Use of hospital discharge records to estimate the incidence of malignant mesotheliomas].

    Science.gov (United States)

    Stura, Antonella; Gangemi, Manuela; Mirabelli, Dario

    2007-01-01

    cancer registries usually adopt strategies for active case finding. Interest in using administrative sources of data is rising to assess the usefullness of Hospital discharge records (HDR) to supplement the traditional methods of case finding of the malignant mesothelioma (MM) Registry of the Piedmont Region. HDRs have been used since 1996. We assessed the number of cases identified only through HDRs and their influence on MM incidence. cases identified through HDRs were about 10% of those with histologic confirmation of the diagnosis, 34% of those with cytologic confirmation, and 72% of those without morphologic examination. Cases diagnosed in hospitals located outside the region would have been easily (50%) missed. The age-standardised (standard: Italian pop. at the 1981 census) incidence rate of pleural MM increases from 2.2 to 2.7 per 100,000 per year among men, and from 1.1 to 1.2 among women, when including all cases identified from HDRs, irrespective of their diagnostic confirmation. Peritoneal MM incidence estimates are unaffected. Overall without access to the hospital discharge files, 179 cases out of 954 would not have been registered between 1996 and 2001. In the same calendar period 59 cases identified by means of active search by the Registry have not been found in the hospital discharge files. HDRs are useful in addition, but not in substitution, to active search of MM cases.

  3. Pending studies at hospital discharge: a pre-post analysis of an electronic medical record tool to improve communication at hospital discharge.

    Science.gov (United States)

    Kantor, Molly A; Evans, Kambria H; Shieh, Lisa

    2015-03-01

    Achieving safe transitions of care at hospital discharge requires accurate and timely communication. Both the presence of and follow-up plan for diagnostic studies that are pending at hospital discharge are expected to be accurately conveyed during these transitions, but this remains a challenge. To determine the prevalence, characteristics, and communication of studies pending at hospital discharge before and after the implementation of an electronic medical record (EMR) tool that automatically generates a list of pending studies. Pre-post analysis. 260 consecutive patients discharged from inpatient general medicine services from July to August 2013. Development of an EMR-based tool that automatically generates a list of studies pending at discharge. The main outcomes were prevalence and characteristics of pending studies and communication of studies pending at hospital discharge. We also surveyed internal medicine house staff on their attitudes about communication of pending studies. Pre-intervention, 70% of patients had at least one pending study at discharge, but only 18% of these were communicated in the discharge summary. Most studies were microbiology cultures (68%), laboratory studies (16%), or microbiology serologies (10%). The majority of study results were ultimately normal (83%), but 9% were newly abnormal. Post-intervention, communication of studies pending increased to 43% (p pending studies, but in usual practice, the presence of these studies has rarely been communicated to outpatient providers in the discharge summary. Communication significantly increased with the implementation of an EMR-based tool that automatically generated a list of pending studies from the EMR and allowed users to import this list into the discharge summary. This is the first study to our knowledge to introduce an automated EMR-based tool to communicate pending studies.

  4. Explicit MDS Codes with Complementary Duals

    DEFF Research Database (Denmark)

    Beelen, Duals Peter; Jin, Lingfei

    2018-01-01

    In 1964, Massey introduced a class of codes with complementary duals which are called Linear Complimentary Dual (LCD for short) codes. He showed that LCD codes have applications in communication system, side-channel attack (SCA) and so on. LCD codes have been extensively studied in literature....... On the other hand, MDS codes form an optimal family of classical codes which have wide applications in both theory and practice. The main purpose of this paper is to give an explicit construction of several classes of LCD MDS codes, using tools from algebraic function fields. We exemplify this construction...

  5. Lessons from the atomic bomb about secondary MDS.

    Science.gov (United States)

    Hata, Tomoko; Imanishi, Daisuke; Miyazaki, Yasushi

    2014-12-01

    Myelodysplastic syndromes (MDSs) is a hematological neoplasm defined by ineffective hematopoiesis, dysplasia of hematopoietic cells, and risk of progression to acute leukemia. MDS occurs as de novo or secondary, and chemoradiotherapy for cancers is thought to increase the risk of MDS among patients. Recently, an epidemiological study for MDS among A-bomb survivors was performed, and it clearly demonstrated that the exposure to external radiation significantly increased the risk of MDS. Precise epidemiological data among survivors have revealed important clinical factors related to the risk of leukemias. In this review, by comparing data for secondary MDS and leukemia/MDS among survivors, several factors which would affect the risk of MDS, especially secondary MDS, are discussed.

  6. GEP analysis validates high risk MDS and acute myeloid leukemia post MDS mice models and highlights novel dysregulated pathways.

    Science.gov (United States)

    Guerenne, Laura; Beurlet, Stéphanie; Said, Mohamed; Gorombei, Petra; Le Pogam, Carole; Guidez, Fabien; de la Grange, Pierre; Omidvar, Nader; Vanneaux, Valérie; Mills, Ken; Mufti, Ghulam J; Sarda-Mantel, Laure; Noguera, Maria Elena; Pla, Marika; Fenaux, Pierre; Padua, Rose Ann; Chomienne, Christine; Krief, Patricia

    2016-01-27

    In spite of the recent discovery of genetic mutations in most myelodysplasic (MDS) patients, the pathophysiology of these disorders still remains poorly understood, and only few in vivo models are available to help unravel the disease. We performed global specific gene expression profiling and functional pathway analysis in purified Sca1+ cells of two MDS transgenic mouse models that mimic human high-risk MDS (HR-MDS) and acute myeloid leukemia (AML) post MDS, with NRASD12 and BCL2 transgenes under the control of different promoters MRP8NRASD12/tethBCL-2 or MRP8[NRASD12/hBCL-2], respectively. Analysis of dysregulated genes that were unique to the diseased HR-MDS and AML post MDS mice and not their founder mice pointed first to pathways that had previously been reported in MDS patients, including DNA replication/damage/repair, cell cycle, apoptosis, immune responses, and canonical Wnt pathways, further validating these models at the gene expression level. Interestingly, pathways not previously reported in MDS were discovered. These included dysregulated genes of noncanonical Wnt pathways and energy and lipid metabolisms. These dysregulated genes were not only confirmed in a different independent set of BM and spleen Sca1+ cells from the MDS mice but also in MDS CD34+ BM patient samples. These two MDS models may thus provide useful preclinical models to target pathways previously identified in MDS patients and to unravel novel pathways highlighted by this study.

  7. GEP analysis validates high risk MDS and acute myeloid leukemia post MDS mice models and highlights novel dysregulated pathways

    Directory of Open Access Journals (Sweden)

    Laura Guerenne

    2016-01-01

    Full Text Available Abstract Background In spite of the recent discovery of genetic mutations in most myelodysplasic (MDS patients, the pathophysiology of these disorders still remains poorly understood, and only few in vivo models are available to help unravel the disease. Methods We performed global specific gene expression profiling and functional pathway analysis in purified Sca1+ cells of two MDS transgenic mouse models that mimic human high-risk MDS (HR-MDS and acute myeloid leukemia (AML post MDS, with NRASD12 and BCL2 transgenes under the control of different promoters MRP8NRASD12/tethBCL-2 or MRP8[NRASD12/hBCL-2], respectively. Results Analysis of dysregulated genes that were unique to the diseased HR-MDS and AML post MDS mice and not their founder mice pointed first to pathways that had previously been reported in MDS patients, including DNA replication/damage/repair, cell cycle, apoptosis, immune responses, and canonical Wnt pathways, further validating these models at the gene expression level. Interestingly, pathways not previously reported in MDS were discovered. These included dysregulated genes of noncanonical Wnt pathways and energy and lipid metabolisms. These dysregulated genes were not only confirmed in a different independent set of BM and spleen Sca1+ cells from the MDS mice but also in MDS CD34+ BM patient samples. Conclusions These two MDS models may thus provide useful preclinical models to target pathways previously identified in MDS patients and to unravel novel pathways highlighted by this study.

  8. Validity of International Classification of Diseases (ICD) coding for dengue infections in hospital discharge records in Malaysia.

    Science.gov (United States)

    Woon, Yuan-Liang; Lee, Keng-Yee; Mohd Anuar, Siti Fatimah Zahra; Goh, Pik-Pin; Lim, Teck-Onn

    2018-04-20

    Hospitalization due to dengue illness is an important measure of dengue morbidity. However, limited studies are based on administrative database because the validity of the diagnosis codes is unknown. We validated the International Classification of Diseases, 10th revision (ICD) diagnosis coding for dengue infections in the Malaysian Ministry of Health's (MOH) hospital discharge database. This validation study involves retrospective review of available hospital discharge records and hand-search medical records for years 2010 and 2013. We randomly selected 3219 hospital discharge records coded with dengue and non-dengue infections as their discharge diagnoses from the national hospital discharge database. We then randomly sampled 216 and 144 records for patients with and without codes for dengue respectively, in keeping with their relative frequency in the MOH database, for chart review. The ICD codes for dengue were validated against lab-based diagnostic standard (NS1 or IgM). The ICD-10-CM codes for dengue had a sensitivity of 94%, modest specificity of 83%, positive predictive value of 87% and negative predictive value 92%. These results were stable between 2010 and 2013. However, its specificity decreased substantially when patients manifested with bleeding or low platelet count. The diagnostic performance of the ICD codes for dengue in the MOH's hospital discharge database is adequate for use in health services research on dengue.

  9. Unraveling the Pathogenesis of MDS: The NLRP3 Inflammasome and Pyroptosis Drive the MDS Phenotype.

    Science.gov (United States)

    Sallman, David A; Cluzeau, Thomas; Basiorka, Ashley A; List, Alan

    2016-01-01

    Myelodysplastic syndromes (MDS) are characterized by bone marrow cytological dysplasia and ineffective hematopoiesis in the setting of recurrent somatic gene mutations and chromosomal abnormalities. The underlying pathogenic mechanisms that drive a common clinical phenotype from a diverse array of genetic abnormalities have only recently begun to emerge. Accumulating evidence has highlighted the integral role of the innate immune system in upregulating inflammatory cytokines via NF-κB activation in the pathogenesis of MDS. Recent investigations implicate activation of the NLRP3 inflammasome in hematopoietic stem/progenitor cells as a critical convergence signal in MDS with consequent clonal expansion and pyroptotic cell death though caspase-1 maturation. Specifically, the alarmin S100A9 and/or founder gene mutations trigger pyroptosis through the generation of reactive oxygen species leading to assembly and activation of the redox-sensitive NLRP3 inflammasome and β-catenin, assuring propagation of the MDS clone. More importantly, targeted inhibition of varied steps in this pathway restore effective hematopoiesis. Together, delineation of the role of pyroptosis in the clinical phenotype of MDS patients has identified novel therapeutic strategies that offer significant promise in the treatment of MDS.

  10. Sensorimotor-correlated discharge recorded from ensembles of cerebellar Purkinje cells varies across the estrous cycle of the rat.

    Science.gov (United States)

    Smith, S S

    1995-09-01

    1. In the present study, locomotor-correlated activity of cerebellar Purkinje cells, recorded using arrays of microwires chronically implanted in adult female rats, was examined across estrous-cycle-associated fluctuations in endogenous sex steroids. Ongoing studies from this laboratory have shown that systemic and local administration of the sex steroid 17 beta-estradiol (E2) augments excitatory responses of cerebellar Purkinje cells to iontophoretically applied glutamate, recorded in vivo from anesthetized female rats. In addition, this steroid potentiated discharge correlated with limb movement. For the present study, extracellular single-unit activity was recorded from as many as 5-11 Purkinje cells simultaneously during treadmill locomotion paradigms. Motor modulation of activity was recorded across three to five consecutive estrous cycles from behaviorally identified cohorts of neurons to test the hypothesis that fluctuations in endogenous sex steroids alter motor modulation of Purkinje cell discharge. 2. Locomotor-associated discharge correlated with treadmill locomotion was increased by a mean of 47% on proestrus, when E2 levels are elevated, relative to diestrus 1. These changes in discharge rate during treadmill locomotion were of significantly greater magnitude than corresponding cyclic alterations in discharge during stationary periods. 3. Correlations with the circadian cycle were also significant, because peak levels of locomotor-associated discharge on the night of behavioral estrus, following elevations in circulating E2, were on average 67% greater than corresponding discharge recorded during the light (proestrus). 4. Alterations in the step cycle were also observed across the estrous cycle: significant decreases in the duration of the flexion phase (by 265 ms, P estrus compared with diestrus. 5. When recorded on estrus, Purkinje cell discharge correlated with the stance or flexion phase of the step cycle was greater in magnitude and preceded the

  11. MDS Nordion - a Canadian success story

    International Nuclear Information System (INIS)

    Boyd, F.

    1998-01-01

    MDS Nordion,the world leading supplier of radioisotopes, had its beginnings as a small division of the crown company Eldorado Mining and Refining Ltd. in the late 1940's. With the end of World War II, Eldorado found itself with a supply of radium left over from the production of uranium during the war and set up a small group in Ottawa to sell it. Most of the stock of radium was disposed of when the development of the NRX reactor made reactor produced radioisotopes possible. The company turned to selling these radioisotopes and soon focused on Cobalt 60 for its use in cancer therapy. In 1952, the group transferred to AECL (Atomic Energy of Canada Ltd.), as part of the Commercial Products Division. In 1988, as part of the federal government's move to privatization, the organization was split into two companies, Theratronics, which manufactures the cancer therapy machines and other equipment for the use of radioisotopes, and Nordion International, which continued the primary business of processing, packaging, selling radioisotopes. In 1991 Nordion International was sold to MDS Inc., a large international group of companies in the life and sciences fields with headquarters in Toronto. The name was changed to MDS Nordion in December 1996

  12. Hemodynamic Response to Interictal Epileptiform Discharges Addressed by Personalized EEG-fNIRS Recordings

    Science.gov (United States)

    Pellegrino, Giovanni; Machado, Alexis; von Ellenrieder, Nicolas; Watanabe, Satsuki; Hall, Jeffery A.; Lina, Jean-Marc; Kobayashi, Eliane; Grova, Christophe

    2016-01-01

    Objective: We aimed at studying the hemodynamic response (HR) to Interictal Epileptic Discharges (IEDs) using patient-specific and prolonged simultaneous ElectroEncephaloGraphy (EEG) and functional Near InfraRed Spectroscopy (fNIRS) recordings. Methods: The epileptic generator was localized using Magnetoencephalography source imaging. fNIRS montage was tailored for each patient, using an algorithm to optimize the sensitivity to the epileptic generator. Optodes were glued using collodion to achieve prolonged acquisition with high quality signal. fNIRS data analysis was handled with no a priori constraint on HR time course, averaging fNIRS signals to similar IEDs. Cluster-permutation analysis was performed on 3D reconstructed fNIRS data to identify significant spatio-temporal HR clusters. Standard (GLM with fixed HRF) and cluster-permutation EEG-fMRI analyses were performed for comparison purposes. Results: fNIRS detected HR to IEDs for 8/9 patients. It mainly consisted oxy-hemoglobin increases (seven patients), followed by oxy-hemoglobin decreases (six patients). HR was lateralized in six patients and lasted from 8.5 to 30 s. Standard EEG-fMRI analysis detected an HR in 4/9 patients (4/9 without enough IEDs, 1/9 unreliable result). The cluster-permutation EEG-fMRI analysis restricted to the region investigated by fNIRS showed additional strong and non-canonical BOLD responses starting earlier than the IEDs and lasting up to 30 s. Conclusions: (i) EEG-fNIRS is suitable to detect the HR to IEDs and can outperform EEG-fMRI because of prolonged recordings and greater chance to detect IEDs; (ii) cluster-permutation analysis unveils additional HR features underestimated when imposing a canonical HR function (iii) the HR is often bilateral and lasts up to 30 s. PMID:27047325

  13. Extraction and characterization of essential discharge patterns from multisite recordings of spiking ongoing activity.

    Directory of Open Access Journals (Sweden)

    Riccardo Storchi

    Full Text Available Neural activation patterns proceed often by schemes or motifs distributed across the involved cortical networks. As neurons are correlated, the estimate of all possible dependencies quickly goes out of control. The complex nesting of different oscillation frequencies and their high non-stationariety further hamper any quantitative evaluation of spiking network activities. The problem is exacerbated by the intrinsic variability of neural patterns.Our technique introduces two important novelties and enables to insulate essential patterns on larger sets of spiking neurons and brain activity regimes. First, the sampling procedure over N units is based on a fixed spike number k in order to detect N-dimensional arrays (k-sequences, whose sum over all dimension is k. Then k-sequences variability is greatly reduced by a hierarchical separative clustering, that assigns large amounts of distinct k-sequences to few classes. Iterative separations are stopped when the dimension of each cluster comes to be smaller than a certain threshold. As threshold tuning critically impacts on the number of classes extracted, we developed an effective cost criterion to select the shortest possible description of our dataset. Finally we described three indexes (C,S,R to evaluate the average pattern complexity, the structure of essential classes and their stability in time.We validated this algorithm with four kinds of surrogated activity, ranging from random to very regular patterned. Then we characterized a selection of ongoing activity recordings. By the S index we identified unstable, moderatly and strongly stable patterns while by the C and the R indices we evidenced their non-random structure. Our algorithm seems able to extract interesting and non-trivial spatial dynamics from multisource neuronal recordings of ongoing and potentially stimulated activity. Combined with time-frequency analysis of LFPs could provide a powerful multiscale approach linking population

  14. Hemodynamic response to Interictal Epileptiform Discharges addressed by personalized EEG-fNIRS recordings

    Directory of Open Access Journals (Sweden)

    Giovanni ePellegrino

    2016-03-01

    Full Text Available Objective: We aimed at studying the hemodynamic response (HR to Interictal Epileptic Discharges (IEDs using patient-specific and prolonged simultaneous ElectroEncephaloGraphy (EEG and functional Near InfraRed Spectroscopy (fNIRS recordings. Methods: The epileptic generator was localized using Magnetoencephalography source imaging. fNIRS montage was tailored for each patient, using an algorithm to optimize the sensitivity to the epileptic generator. Optodes were glued using collodion to achieve prolonged acquisition with high quality signal. fNIRS data analysis was handled with no a priori constraint on HR time course, averaging fNIRS signals to similar IEDs. Cluster-permutation analysis was performed on 3D reconstructed fNIRS data to identify significant spatio-temporal HR clusters. Standard (GLM with fixed HRF and cluster-permutation EEG-fMRI analyses were performed for comparison purposes. Results: fNIRS detected HR to IEDs for 8/9 patients. It mainly consisted oxy-hemoglobin increases (7 patients, followed by oxy-hemoglobin decreases (6 patients. HR was lateralized in 6 patients and lasted from 8.5 to 30s. Standard EEG-fMRI analysis detected an HR in 4/9 patients (4/9 without enough IEDs, 1/9 unreliable result. The cluster-permutation EEG-fMRI analysis restricted to the region investigated by fNIRS showed additional strong and non-canonical BOLD responses starting earlier than the IEDs and lasting up to 30s. Conclusions: i EEG-fNIRS is suitable to detect the HR to IEDs and can outperform EEG-fMRI because of prolonged recordings and greater chance to detect IEDs; ii cluster-permutation analysis unveils additional HR features underestimated when imposing a canonical HR function iii the HR is often bilateral and lasts up to 30s.

  15. We need to talk: Primary care provider communication at discharge in the era of a shared electronic medical record.

    Science.gov (United States)

    Sheu, Leslie; Fung, Kelly; Mourad, Michelle; Ranji, Sumant; Wu, Ethel

    2015-05-01

    Poor communication between hospitalists and outpatient physicians can contribute to adverse events after discharge. Electronic medical records (EMRs) shared by inpatient and outpatient clinicians offer primary care providers (PCPs) better access to information surrounding a patient's hospitalization. However, the PCP experience and subsequent expectations for discharge communication within a shared EMR are unknown. We surveyed PCPs 1 year after a shared EMR was implemented at our institution to assess PCP satisfaction with current discharge communication practices and identify areas for improvement. Seventy-five of 124 (60%) clinicians completed the survey. Although most PCPs reported receiving automated discharge notifications (71%), only 39% felt that notifications plus discharge summaries were adequate for safe transitions of care. PCPs expressed that complex hospitalizations necessitated additional communication via e-mail or telephone; only 31% reported receiving such communication. The content most important in additional communication included medication changes, follow-up actions, and active medical issues. Despite optimized access to information provided by a shared EMR, only 52% of PCPs were satisfied with current discharge communication. PCPs express a continued need for high-touch communication for safe transitions of care. Further standardization of discharge communication practices is necessary. © 2015 Society of Hospital Medicine.

  16. Detection of Interictal Epileptiform Discharges Using Signal Envelope Distribution Modelling: Application to Epileptic and Non-Epileptic Intracranial Recordings

    Czech Academy of Sciences Publication Activity Database

    Janča, R.; Ježdík, P.; Čmejla, R.; Tomášek, M.; Worrell, G. A.; Stead, M.; Wagenaar, J.; Jefferys, J. G. R.; Kršek, P.; Komárek, V.; Jiruška, Přemysl; Marusič, P.

    2015-01-01

    Roč. 28, č. 1 (2015), s. 172-183 ISSN 0896-0267 Grant - others:GA Mzd(CZ) NT11460 Institutional support: RVO:67985823 Keywords : spike detection * interictal epileptiform discharges * intracranial recording * automatic detection * Hilbert transform * principal component analysis Subject RIV: FH - Neurology Impact factor: 3.727, year: 2015

  17. Occurrence of epileptiform discharges and sleep during EEG recordings in children after melatonin intake versus sleep-deprivation.

    Science.gov (United States)

    Gustafsson, Greta; Broström, Anders; Ulander, Martin; Vrethem, Magnus; Svanborg, Eva

    2015-08-01

    To determine if melatonin is equally efficient as partial sleep deprivation in inducing sleep without interfering with epileptiform discharges in EEG recordings in children 1-16 years old. We retrospectively analysed 129 EEGs recorded after melatonin intake and 113 EEGs recorded after partial sleep deprivation. Comparisons were made concerning occurrence of epileptiform discharges, the number of children who fell asleep and the technical quality of EEG recordings. Comparison between different age groups was also made. No significant differences were found regarding occurrence of epileptiform discharges (33% after melatonin intake, 36% after sleep deprivation), or proportion of unsuccessful EEGs (8% and 10%, respectively). Melatonin and sleep deprivation were equally efficient in inducing sleep (70% in both groups). Significantly more children aged 1-4 years obtained sleep after melatonin intake in comparison to sleep deprivation (82% vs. 58%, p⩽0.01), and in comparison to older children with melatonin induced sleep (58-67%, p⩽0.05). Sleep deprived children 9-12 years old had higher percentage of epileptiform discharges (62%, p⩽0.05) compared to younger sleep deprived children. Melatonin is equally efficient as partial sleep deprivation to induce sleep and does not affect the occurrence of epileptiform discharges in the EEG recording. Sleep deprivation could still be preferable in older children as melatonin probably has less sleep inducing effect. Melatonin induced sleep have advantages, especially in younger children as they fall asleep easier than after sleep deprivation. The procedure is easier for the parents than keeping a young child awake for half the night. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  18. Downregulation of MMP1 in MDS-derived mesenchymal stromal cells reduces the capacity to restrict MDS cell proliferation.

    Science.gov (United States)

    Zhao, Sida; Zhao, Youshan; Guo, Juan; Fei, Chengming; Zheng, Qingqing; Li, Xiao; Chang, Chunkang

    2017-03-06

    The role of mesenchymal stromal cells (MSCs) in the pathogenesis of myelodysplastic syndromes (MDS) has been increasingly addressed, but has yet to be clearly elucidated. In this investigation, we found that MDS cells proliferated to a greater extent on MDS-derived MSCs compared to normal MSCs. Matrix metalloproteinase 1(MMP1), which was downregulated in MDS-MSCs, was identified as an inhibitory factor of MDS cell proliferation, given that treatment with an MMP1 inhibitor or knock-down of MMP1 in normal MSCs resulted in increased MDS cell proliferation. Further investigations indicated that MMP1 induced apoptosis of MDS cells by interacting with PAR1 and further activating the p38 MAPK pathway. Inhibition of either PAR1 or p38 MAPK can reverse the apoptosis-inducing effect of MMP1. Taken together, these data indicate that downregulation of MMP1 in MSCs of MDS patients may contribute to the reduced capacity of MSCs to restrict MDS cell proliferation, which may account for the malignant proliferation of MDS cells.

  19. New proposals of the WHO working group (2016) for the diagnosis of myelodysplastic syndromes (MDS): Characteristics of refined MDS types.

    Science.gov (United States)

    Strupp, Corinna; Nachtkamp, Kathrin; Hildebrandt, Barbara; Giagounidis, Aristoteles; Haas, Rainer; Gattermann, Norbert; Bennett, John M; Aul, Carlo; Germing, Ulrich

    2017-06-01

    Based on centrally diagnosed 3528 patients in the Düsseldorf registry, we validated the new proposals for the classification of the MDS by the WHO working group: 256 patients were diagnosed as MDSSLD (7,3%), 978 MDSMLD (27,7%), 227 MDS RS SLD (6,4%); 321 MDS RS MLD (9,1%), 159 MDS del(5q) (4,5%), 481 MDSEB 1 (13,6%), 620 MDSEB 2 (17,6%), and 148 MDS-U (4,2%). 352 patients (16,9% of the non blastic types) changed the category, mainly moving from RCMD to MDS RS MLD, RCUD and RCMD to MDS del(5q). Median survival times of the refined groups differed from more than 60 months in the MDSSLD (RS) groups, 37 months in the MDSMLD (RS) groups, 79 months of the MDS del(5q) group and 21 and 11 months in the MDSEB 1 and 2 groups, respectively. The difference between the groups with regard to the risk of AML evolution was also impressing. No major changes were made with regard to the MDS-U categories. In summary, the proposals of the WHO group for the classification of MDS are thoughtful, taking into account biologic parameters of the diseases, a more precise wording, to some extend pragmatic and feasible. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Management of older adults with myelodysplastic syndromes (MDS).

    Science.gov (United States)

    Luskin, Marlise R; Abel, Gregory A

    2017-12-28

    The myelodysplastic syndromes (MDS) are a varied group of hematologic neoplasms that lead to bone marrow failure, and also carry a risk of progression to acute myeloid leukemia. Patients with MDS suffer significant impairments to both their quality of life and survival. Age is the dominant risk factor for the development of MDS, with a median age at diagnosis over 70years. Consequently, patients with MDS frequently have concurrent comorbidities and/or frailty which may be coincident or related to the disease itself. Disease characteristics, degree of comorbidity, and presence of frailty all impact prognosis. Treatment of MDS focuses on supportive care, with disease-modifying approaches (chemotherapy and allogeneic hematopoietic cell transplantation) reserved for fit patients with high-risk disease. Care of patients with MDS requires understanding the disease in the context of an older population, and tailoring approaches to both disease risk and patient suitability for therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Construction of new quantum MDS codes derived from constacyclic codes

    Science.gov (United States)

    Taneja, Divya; Gupta, Manish; Narula, Rajesh; Bhullar, Jaskaran

    Obtaining quantum maximum distance separable (MDS) codes from dual containing classical constacyclic codes using Hermitian construction have paved a path to undertake the challenges related to such constructions. Using the same technique, some new parameters of quantum MDS codes have been constructed here. One set of parameters obtained in this paper has achieved much larger distance than work done earlier. The remaining constructed parameters of quantum MDS codes have large minimum distance and were not explored yet.

  2. MDS: Recent progress in molecular pathogenesis and clinical aspects.

    Science.gov (United States)

    Harada, Hironori

    2017-01-01

    Myelodysplastic syndromes (MDS) are defined as hematopoietic stem cell disorders caused by various gene abnormalities. Recent analysis using next generation sequencing has provided great progress in identifying relationships between gene mutations and clinical phenotypes of MDS. It is estimated that one or more gene mutations occur in greater than 90% of MDS patients. More than 50 gene mutations affecting RNA splicing machinery, DNA methylation, histone modifications, transcription factors, signal transduction proteins, and components of the cohesion complex participate in the pathogenesis of MDS. The sequential accumulation of additional cooperating mutations drives disease evolution from clonal hematopoiesis of indeterminate potential (CHIP) to symptomatic MDS and from MDS to acute myelogenous leukemia (AML). Mutations in RNA splicing and DNA methylation occur early and are considered founding mutations, whereas others that occur later are regarded as subclonal mutations. RUNX1 mutations are more likely to be subclonal; however, they apparently play a pivotal role in familial MDS. In addition, large alterations of chromosomes are involved in the pathogenesis of MDS. 5q- syndrome, which leads to haploinsufficiency of the located genes, has consistent clinical features. Understanding gene abnormalities of MDS patients can provide clinical information, including diagnosis, prognostic score, and prediction of response to therapy.

  3. Are the MDS-UPDRS-based composite scores clinically applicable?

    Science.gov (United States)

    Makkos, Attila; Kovács, Márton; Aschermann, Zsuzsanna; Harmat, Márk; Janszky, József; Karádi, Kázmér; Kovács, Norbert

    2018-02-28

    The International Parkinson and Movement Disorder Society-sponsored UPDRS (MDS-UPDRS) is a powerful clinical outcome measure. To evaluate the feasibility of various MDS-UPDRS-based composite scores and determine their minimal clinically important difference threshold values. Overall, 1,113 paired investigations of 452 patients were reviewed implementing three different techniques simultaneously. Based on the ordinal regression modeling, the MDS-UPDRS II+III, MDS-UPDRS I+II+III, and the total score of MDS-UPDRS are clinically applicable outcome measures. Any improvement greater than 4.9 points or any worsening more than 4.2 points on MDS-UPDRS II+III represent a minimal, yet clinically meaningful, change. In reference to MDS-UPDRS I+II+III, the smallest changes considered clinically relevant were 6.7 and 5.2 points for improvement and deterioration, respectively. The thresholds for the total score of MDS-UPDRS were 7.1 points for improvement and 6.3 points for worsening. Our findings support the application of various MDS-UPDRS-based composite scores. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

  4. MDS classification is improving in an era of the WHO 2016 criteria of MDS: A population-based analysis among 9159 MDS patients diagnosed in the Netherlands.

    Science.gov (United States)

    Dinmohamed, Avinash G; Visser, Otto; Posthuma, Eduardus F M; Huijgens, Peter C; Sonneveld, Pieter; van de Loosdrecht, Arjan A; Jongen-Lavrencic, Mojca

    2017-10-01

    Morphologic and cytogenetic assessments are required to characterize diagnostic and prognostic features of myelodysplastic syndromes (MDS). We assessed whether these assessments were performed among newly diagnosed MDS patients in the Netherlands. MDS cases were retrieved from the nationwide Netherlands Cancer Registry (N=9159; period 2001-2014) and the regional PHAROS MDS registry (N=676; period 2008-2011). The proportion of unclassified MDS decreased from 58% in 2001 to 13% in 2014. Data from the more detailed PHAROS registry revealed that the degree of bone marrow dysplasia was only reported in ∼30% of all evaluable bone marrow aspirates. Further, the International Prognostic Scoring System was undetermined in 55% of patients, primarily owing to unperformed cytogenetics in 46% of patients. The classification of MDS is improving in the Netherlands. Nevertheless, particular diagnostic and prognostic procedures that are essential for the diagnosis and subsequent treatment decision-making of MDS were not fully utilized in particular patient subsets. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Quality of medication information in discharge summaries from hospitals: an audit of electronic patient records.

    Science.gov (United States)

    Garcia, Beate Hennie; Djønne, Berit Svendsen; Skjold, Frode; Mellingen, Ellen Marie; Aag, Trine Iversen

    2017-12-01

    Background Low quality of medication information in discharge summaries from hospitals may jeopardize optimal therapy and put the patient at risk for medication errors and adverse drug events. Objective To audit the quality of medication information in discharge summaries and explore factors associated with the quality. Setting Helgelandssykehuset Mo i Rana, a rural hospital in central Norway. Method For each month in 2013, we randomly selected 60 discharge summaries from the Department of Medicine and Surgery (totally 720) and evaluated the medication information using eight Norwegian quality criteria. Main outcome measure Mean score per discharge summary ranging from 0 (lowest quality) to 16 (highest quality). Results Mean score per discharge summary was 7.4 (SD 2.8; range 0-14), significantly higher when evaluating medications used regularly compared to mediations used as needed (7.80 vs. 6.52; p < 0.001). Lowest score was achieved for quality criteria concerning generic names, indications for medication use, reasons why changes had been made and information about the source for information. Factors associated with increased quality scores are increasing numbers of medications and male patients. Increasing age seemed to be associated with a reduced score, while type of department was not associated with the quality. Conclusion In discharge summaries from 2013, we identified a low quality of medication information in accordance with the Norwegian quality criteria. Actions for improvement are necessary and follow-up studies to monitor quality are needed.

  6. Distinct mutation profile and prognostic relevance in patients with hypoplastic myelodysplastic syndromes (h-MDS).

    Science.gov (United States)

    Yao, Chi-Yuan; Hou, Hsin-An; Lin, Tzung-Yi; Lin, Chien-Chin; Chou, Wen-Chien; Tseng, Mei-Hsuan; Chiang, Ying-Chieh; Liu, Ming-Chih; Liu, Chia-Wen; Kuo, Yuan-Yeh; Wu, Shang-Ju; Liao, Xiu-Wen; Lin, Chien-Ting; Ko, Bor-Shen; Chen, Chien-Yuan; Hsu, Szu-Chun; Li, Chi-Cheng; Huang, Shang-Yi; Yao, Ming; Tang, Jih-Luh; Tsay, Woei; Liu, Chieh-Yu; Tien, Hwei-Fang

    2016-09-27

    Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic malignancies. Although most MDS patients have normal or increased BM cellularity (NH-MDS), some have hypocellular BM (h-MDS). The reports concerning the differences in genetic alterations between h-MDS and NH-MDS patients are limited. In this study, 369 MDS patients diagnosed according to the WHO 2008 criteria were recruited. h-MDS patients had lower PB white blood cell and blast counts, and lower BM blast percentages, than those with NH-MDS. h-MDS was closely associated with lower-risk MDS, defined by the International Prognostic Scoring System (IPSS) and revised IPSS (IPSS-R). IPSS-R could properly predict the prognosis in h-MDS (PMDS patients. The h-MDS patients had lower incidences of RUNX1, ASXL1, DNMT3A, EZH2 and TP53 mutations than NH-MDS patients. The cumulated incidence of acute leukemic transformation at 5 years was 19.3% for h-MDS and 40.4% for NH-MDS patients (P= 0.001). Further, the patients with h-MDS had longer overall survival (OS) than those with NH-MDS (P= 0.001), and BM hypocellularity remains an independent favorable prognostic factor for OS irrespective of age, IPSS-R, and gene mutations. Our findings provide evidence that h-MDS indeed represent a distinct clinico-biological subgroup of MDS and can predict better leukemia-free survival and OS.

  7. Construction of MDS self-dual codes from orthogonal matrices

    OpenAIRE

    Shi, Minjia; Sok, Lin; Solé, Patrick

    2016-01-01

    In this paper, we give algorithms and methods of construction of self-dual codes over finite fields using orthogonal matrices. Randomization in the orthogonal group, and code extension are the main tools. Some optimal, almost MDS, and MDS self-dual codes over both small and large prime fields are constructed.

  8. The drift-flux correlation package MDS

    International Nuclear Information System (INIS)

    Hoeld, A.

    2001-01-01

    Based on the SONNENBURG drift-flux correlation, developed at GRS/Garching (Germany), a comprehensive drift-flux correlation package (MDS) has been established. Its aim is to support thermal-hydraulic mixture-fluid models, models being used for the simulation of the steady state and transient behaviour of characteristic thermal-hydraulic parameters of single- or two-phase fluids flowing along coolant channels of different types (being, e.g., parts of NPP-s, steam generators etc.). The characteristic properties of this package with respect to the behaviour at co- and counter-current flow, its inverse solutions needed for steady state simulations, its behaviour when approaching the lower or upper boundary of a two-phase region, its verification and behaviour with respect to other correlations will be discussed. An adequate driver code, MDSDRI, has been established too, allowing to test the package very thoroughly out of the complex thermal-hydraulic codes. (author)

  9. The drift-flux correlation package MDS

    Energy Technology Data Exchange (ETDEWEB)

    Hoeld, A. [Bernaysstr. 16A, Munich, F.R. (Germany)

    2001-07-01

    Based on the SONNENBURG drift-flux correlation, developed at GRS/Garching (Germany), a comprehensive drift-flux correlation package (MDS) has been established. Its aim is to support thermal-hydraulic mixture-fluid models, models being used for the simulation of the steady state and transient behaviour of characteristic thermal-hydraulic parameters of single- or two-phase fluids flowing along coolant channels of different types (being, e.g., parts of NPP-s, steam generators etc.). The characteristic properties of this package with respect to the behaviour at co- and counter-current flow, its inverse solutions needed for steady state simulations, its behaviour when approaching the lower or upper boundary of a two-phase region, its verification and behaviour with respect to other correlations will be discussed. An adequate driver code, MDSDRI, has been established too, allowing to test the package very thoroughly out of the complex thermal-hydraulic codes. (author)

  10. Myelodysplastic changes mimicking MDS following treatment for osteosarcoma

    DEFF Research Database (Denmark)

    Løhmann, Ditte

    -MDS/AML) is a feared long-term complication of paediatric cancer including osteosarcoma. Few develop t-MDS/AML, but it is not known how many have significant haematological changes after finishing treatment for osteosarcoma. In this study we reviewed biochemistry from a consecutive series of children for up to two...... years after finishing treatment. We included all children (n=14) who where diagnosed from October 2006 to January 2011 at our department and treated according to the EURAMOS-1 protocol. Four patients relapsed and died before the end of the study period. We found noteworthy changes in MCV, platelets...... for osteosarcoma developed haematological abnormalities similar to early MDS but few developed t-MDS/AML. Close monitoring of patients recovering from osteosarcoma is essential. Keywords: Osteosarcoma, t-MDS/AML, Haematological abnormalities, Children...

  11. An Exercise in Extrapolation: Clinical Management of Atypical CML, MDS/MPN-Unclassifiable, and MDS/MPN-RS-T.

    Science.gov (United States)

    Talati, Chetasi; Padron, Eric

    2016-12-01

    According to the recently published 2016 World Health Organization (WHO) classification of myeloid malignancies, myelodysplastic/myeloproliferative neoplasms (MDS/MPN) include atypical chronic myeloid leukemia (aCML), MDS/MPN-unclassifiable (MDS/MPN-U), chronic myelomonocytic leukemia (CMML), juvenile myelomonocytic leukemia (JMML), and MDS/MPN ring sideroblasts with thrombocytosis (MDS/MPN-RS-T). MDS/MPN-RS-T was previously a provisional category known as refractory anemia with ring sideroblasts with thrombocytosis (RARS-T) which has now attained a distinct designation in the 2016 WHO classification. In this review, we focus on biology and management of aCML, MDS/MPN-U, and MDS/MPN-RS-T. There is considerable overlap between these entities which we attempt to further elucidate in this review. We also discuss recent advances in the field of molecular landscape that further defines and characterizes this heterogeneous group of disorders. The paucity of clinical trials available secondary to unclear pathogenesis and rarity of these diseases makes the management of these entities clinically challenging. This review summarizes some of the current knowledge of the molecular pathogenesis and suggested treatment guidelines based on the available data.

  12. Diagnosis, management and response criteria of iron overload in myelodysplastic syndromes (MDS): updated recommendations of the Austrian MDS platform.

    Science.gov (United States)

    Valent, Peter; Stauder, Reinhard; Theurl, Igor; Geissler, Klaus; Sliwa, Thamer; Sperr, Wolfgang R; Bettelheim, Peter; Sill, Heinz; Pfeilstöcker, Michael

    2018-02-01

    Despite the availability of effective iron chelators, transfusion-related morbidity is still a challenge in chronically transfused patients with myelodysplastic syndromes (MDS). In these patients, transfusion-induced iron overload may lead to organ dysfunction or even organ failure. In addition, iron overload is associated with reduced overall survival in MDS. Areas covered: During the past 10 years, various guidelines for the management of MDS patients with iron overload have been proposed. In the present article, we provide our updated recommendations for the diagnosis, prevention and therapy of iron overload in MDS. In addition, we propose refined treatment response criteria. As in 2006 and 2007, recommendations were discussed and formulated by participants of our Austrian MDS platform in a series of meetings in 2016 and 2017. Expert commentary: Our updated recommendations should support early recognition of iron overload, optimal patient management and the measurement of clinical responses to chelation treatment in daily practice.

  13. Using the tracer-dilution discharge method to develop streamflow records for ice-affected streams in Colorado

    Science.gov (United States)

    Capesius, Joseph P.; Sullivan, Joseph R.; O'Neill, Gregory B.; Williams, Cory A.

    2005-01-01

    Accurate ice-affected streamflow records are difficult to obtain for several reasons, which makes the management of instream-flow water rights in the wintertime a challenging endeavor. This report documents a method to improve ice-affected streamflow records for two gaging stations in Colorado. In January and February 2002, the U.S. Geological Survey, in cooperation with the Colorado Water Conservation Board, conducted an experiment using a sodium chloride tracer to measure streamflow under ice cover by the tracer-dilution discharge method. The purpose of this study was to determine the feasibility of obtaining accurate ice-affected streamflow records by using a sodium chloride tracer that was injected into the stream. The tracer was injected at two gaging stations once per day for approximately 20 minutes for 25 days. Multiple-parameter water-quality sensors at the two gaging stations monitored background and peak chloride concentrations. These data were used to determine discharge at each site. A comparison of the current-meter streamflow record to the tracer-dilution streamflow record shows different levels of accuracy and precision of the tracer-dilution streamflow record at the two sites. At the lower elevation and warmer site, Brandon Ditch near Whitewater, the tracer-dilution method overestimated flow by an average of 14 percent, but this average is strongly biased by outliers. At the higher elevation and colder site, Keystone Gulch near Dillon, the tracer-dilution method experienced problems with the tracer solution partially freezing in the injection line. The partial freezing of the tracer contributed to the tracer-dilution method underestimating flow by 52 percent at Keystone Gulch. In addition, a tracer-pump-reliability test was conducted to test how accurately the tracer pumps can discharge the tracer solution in conditions similar to those used at the gaging stations. Although the pumps were reliable and consistent throughout the 25-day study period

  14. Progress in the diagnosis of and therapy for MDS.

    Science.gov (United States)

    Nannya, Yasuhito

    2016-01-01

    The WHO classification system of MDS 4 th edition was recently updated. This revision includes nomenclature changes, reflecting the policy of the revision team to emphasize morphological features over cytopenias. Other changes are 1) taking SF3B1 mutation status into account for the definition criteria of MDS-RS (ring sideroblasts), 2) allowing for one additional cytogenetic abnormality (excluding -7/del (7q)) to be diagnosed as 'MDS with isolated del (5q)', 3) sub-classifying MDS-U according to the reasons for being included in this category, and 4) changing the diagnostic rules for myeloid neoplasms with erythroid blast predominance. This session also deals with recent topics in hematopoietic stem cell transplantation (HSCT) as an example of progress in therapy for MDS. Although HSCT is the only curative therapy for MDS, high treatment related mortality precludes its applicability especially for elderly patients, for whom demethylating agents are an alternative. Recently, reports on both well-designed retrospective or prospective studies have validated the advantage of HSCT over demethylating agents for patients of comparatively advanced age with higher risk MDS. Optimal intensity of conditioning regimens for HSCT is another controversial topic for which preliminary results of randomized controlled trials have been released and will be introduced in this session.

  15. MDS clinical diagnostic criteria for Parkinson's disease in China.

    Science.gov (United States)

    Li, Jun; Jin, Miao; Wang, Li; Qin, Bin; Wang, Kang

    2017-03-01

    The Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (MDS-PD Criteria) was introduced by the Movement Disorder Society in 2015 for research purposes. However, its use for clinical diagnosis of Parkinson disease still needs further revision. This study compares the UK-Criteria versus MDS-PD Criteria in the clinical diagnosis of Parkinson disease referred to the China-Japan Friendship Hospital of Beijing, China. To compare the MDS-PD Criteria with the UK-Criteria and discuss the feasibility of the clinical application of MDS-PD Criteria as a general guide to clinical diagnosis of PD in Chinese PD patients. 150 patients of neurology clinic of China-Japan Friendship Hospital of Beijing were recruited in our research. They were divided into three groups: UK-Criteria group, MDS-PD Criteria group and a combined group of UK and MDS-PD Criteria. Clinical history was collected while physical and auxiliary examinations were done by a trained neurologist according to the corresponding criteria. An interrater reliability analysis using the Kappa statistic claimed substantial agreement (κ = 0.626) between the MDS-PD Criteria and the UK-Criteria. The differences between the diagnostic results of these two criteria were statistically significant by paired Chi-square test (p = 0.000). It was found that levodopa-induced dyskinesia had a good positive predictive value, while early bulbar impairment and inspiratory dysfunction presented a negative predictive value. The MDS-PD Criteria emphasize the importance of non-motor symptoms, keeping the motor symptoms as the core for the clinical diagnosis of PD, and establish categories of diagnosis features and levels of certainty which are more complete and organized to be used and replicated by non specialized physicians to evaluated patients with Parkinsonism. The higher sensitivity of MDS-PD Criteria compared with UK-Criteria is worth being widely used in clinical work.

  16. MDS. A disease with high radiation-risk

    International Nuclear Information System (INIS)

    Ban, Sadayuki; Sudo, Hitomi; Saegusa, Kumiko; Sagara, Masashi; Imai, Takashi

    2003-01-01

    A preliminary epidemiological study demonstrated that myelodysplastic syndrome (MDS) has an excess relative risk per sievert of 13 in atomic bomb survivors. MDS is the only other radiogenic blood disease apart from leukemia. Clinically, MDS involves dysplastic hematopoiesis and an increased risk of leukemic transformation. Because it is uncertain whether MDS pathogenesis affects lymphoid progenitor cells as well as myeloid progenitor cells, we investigated the micronucleus (MN) frequency in peripheral T lymphocytes of twenty-three atomic bomb survivors with MDS and five normal individuals. The spontaneous- and X-ray-induced-MN frequencies were significantly higher in MDS patients than in normal individuals. Interestingly, radiation sensitivity increased along with the severity of MDS clinical subtypes. Because many of the patients in this study had not been exposed to chemo- or radiation-therapy, their unusual radiosensitivities may be related to their chromosomal or genomic instability. To explain the cause of unusual radiosensitivity, we measured the expression levels of four nucleotide excision repair (NER) genes (ERCC1, ERCC3, ERCC5 and XPC) in peripheral blood mononuclear cells using a reverse transcripts-polymerase chain reaction (RT-PCR) method. The ERCC5 gene was expressed at reduced levels in only one of 10 patients with mild symptom. Reduction of NER genes was expressed in four of 11 patients with severe symptom. Immortalized lymphoid cell lines were established from B-lymphocytes infected with Epstein-Barr virus in vitro. The abrogation of radiation-induced-G2/M arrnst was observed in some of MDS-B lymphoid cell lines, but not in the normal B lymphoid cell lines. Our data suggest that the control of chromosomal stability is impaired in pluripotent stem cells of MDS patients, and that DNA repair defects and loss of G2/M arrest may be involved in the pathophysiology of disease progression. (authors)

  17. Implication of microRNAs in the Pathogenesis of MDS

    Science.gov (United States)

    Fang, Jing; Varney, Melinda; Starczynowski, Daniel T.

    2016-01-01

    MicroRNAs (miRNAs) are significant regulators of human hematopoietic stem cells (HSC), and their deregulation contributes to hematological malignancies. Myelodysplastic syndromes (MDS) represent a spectrum of hematological disorders characterized by dysfunctional HSC, ineffective blood cell production, progressive marrow failure, and an increased risk of developing acute myeloid leukemia (AML). Although miRNAs have been primarily studied in AML, only recently have similar studies been performed on MDS. In this review, we describe the normal function and expression of miRNAs in human HSC, and describe mounting evidence that deregulation of miRNAs contributes to the pathogenesis of MDS. PMID:22571695

  18. [Clinical Significance of ID4 Gene Mehtylation in Demethylation-Treated MDS Cell Line and 2 MDS Patients].

    Science.gov (United States)

    Kang, Hui-Yuan; Wang, Xin-Rong; Gao, Li; Wang, Wei; Li, Mian-Yang; Wang, Li-Li; Wang, Cheng-Bin; Yu, Li

    2015-04-01

    To evaluate significance of ID4 gene mehtylation in demethylating myelodysplastic syndrome(MDS) cell Line MUTZ1 and 2 patients with MDS. The methylation-specific PCR (MS-PCR) and reverse transcription-PCR (RT-PCR) were applied to identify the methylation status and gene expression of ID4 gene in MDS cell line MUTZ1, a patient with aplastic anemia(AA) and a donor with normal bone marrow (NBM). RT-PCR was applied to detect the ID4 gene expression status in MUTZ1 cell line treated with decitabine at 3 different concentrations. Then bisulfite sequencing PCR (BSP) was applied to detect ID4 gene methylation status in 2 MDS parients treated with decitabine. The MDS cell line MUTZ-1 displayed a complete methylation of ID4 gene promoter with little mRNA expression. Inversely, bone marrow of an AA patient and NBM showed complete unmethylation of this gene with intensity mRNA expression. With the increase of decitabine concentration, ID4 gene mRNA expression was more and more increased. After decitabine treatment, ID4 gene methylation-positive frequencies of both the 2 MDS patients were much more decreased than that of the first treatment. So, ID4 gene mRNA expression inhibited by promoter hypemethylation could be recovered by using demethylation medicine. ID4 as a new potential anti-oncogene suggests that its methylation may become a marker for selection and assessment of therapeutic schedules in patients with MDS.

  19. Myelodysplastic Syndrome, Unclassifiable (MDS-U) With 1% Blasts Is a Distinct Subgroup of MDS-U With a Poor Prognosis.

    Science.gov (United States)

    Margolskee, Elizabeth; Hasserjian, Robert P; Hassane, Duane; Tam, Wayne; Mathew, Susan; Ok, Chi Young; Wang, Sa A; Oak, Jean; Arber, Daniel A; Orazi, Attilio

    2017-07-01

    Three situations qualify as myelodysplastic syndrome, unclassifiable (MDS-U): (1) refractory cytopenia with dysplasia and 1% blasts in peripheral blood (BL), (2) pancytopenia with unilineage dysplasia (Pan), and (3) persistent cytopenia, less than 5% bone marrow blasts, and less than 10% dysplastic cells and presence of MDS-defining cytogenetic abnormalities (CG). We compared the clinicopathologic features and mutational profiles for these three groups. MDS-U cases were reviewed at four major academic institutions. Targeted next-generation sequencing for genes implicated in myeloid neoplasms was performed in a subset of cases. Twenty-seven patients were identified (six MDS-U BL, 13 MDS-U Pan, and eight MDS-U CG). Clonal cytogenetic abnormalities were found in six of six, seven of 13, and eight of eight cases in MDS-U BL, Pan, and CG, respectively (P > .05). Overall, four of six patients with MDS-U BL progressed to acute myeloid leukemia; no MDS-U Pan or CG patients did. The rates of progression-free survival and mortality (overall survival) were significantly higher in MDS-U BL compared with Pan and CG (P MDS-U BL is a distinct subset of MDS-U with a poor prognosis, while MDS-U Pan and CG are relatively indolent. Evaluation of peripheral blood smears in patients with MDS is essential for accurate classification and prognosis. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  20. Resident Assessment Instrument/Minimum Data Set (RAI/MDS)

    Data.gov (United States)

    Department of Veterans Affairs — The Resident Assessment Instrument/Minimum Data Set (RAI/MDS) is a comprehensive assessment and care planning process used by the nursing home industry since 1990 as...

  1. MDS 2.0 Public Quality Indicator and Resident Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Minimum Data Set (MDS) is part of the federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes. This...

  2. An improved resource management model based on MDS

    Science.gov (United States)

    Yuan, Man; Sun, Changying; Li, Pengfei; Sun, Yongdong; He, Rui

    2005-11-01

    GRID technology provides a kind of convenient method for managing GRID resources. This service is so-called monitoring, discovering service. This method is proposed by Globus Alliance, in this GRID environment, all kinds of resources, such as computational resources, storage resources and other resources can be organized by MDS specifications. However, this MDS is a theory framework, particularly, in a small world intranet, in the case of limit of resources, the MDS has its own limitation. Based on MDS, an improved light method for managing corporation computational resources and storage resources is proposed in intranet(IMDS). Firstly, in MDS, all kinds of resource description information is stored in LDAP, it is well known although LDAP is a light directory access protocol, in practice, programmers rarely master how to access and store resource information into LDAP store, in such way, it limits MDS to be used. So, in intranet, these resources' description information can be stored in RDBMS, programmers and users can access this information by standard SQL. Secondly, in MDS, how to monitor all kinds of resources in GRID is not transparent for programmers and users. In such way, it limits its application scope, in general, resource monitoring method base on SNMP is widely employed in intranet, therefore, a kind of resource monitoring method based on SNMP is integrated into MDS. Finally, all kinds of resources in the intranet can be described by XML, and all kinds of resources' description information is stored in RDBMS, such as MySql, and retrieved by standard SQL, dynamic information for all kinds of resources can be sent to resource storage by SNMP, A prototype resource description, monitoring is designed and implemented in intranet.

  3. Modeling Marrow Failure and MDS for Novel Therapeutics

    Science.gov (United States)

    2017-03-01

    syndrome (MDS) and leukemia is also markedly elevated in patients with inherited marrow failure syndromes compared to age-matched controls. Prognosis of...Novel Therapeutics W81XWH-16-1-0054 1. Introduction Clonal evolution is a potentially life threatening long-term complication of inherited and...The risk of early progression to myelodysplastic syndrome (MDS) and leukemia is also markedly elevated in patients with inherited marrow failure

  4. Myelodysplastic Syndromes (MDS) and autoimmune disorders (AD): cause or consequence?

    Science.gov (United States)

    Braun, Thorsten; Fenaux, Pierre

    2013-12-01

    Myelodysplastic Syndromes (MDS) and Chronic Myelomonocytic Leukemia (CMML) are frequently associated with clinical manifestations of autoimmune disorders (AD) and inflammatory response of the immune system. AD accompanying MDS and CMML include vasculitis, seronegative polyarthritis and neutrophilic dermatosis. Rare AD including relapsing polychondritis is strongly associated with MDS as in a high proportion of those patients MDS is diagnosed during disease course. Antinuclear antibodies (ANA) are frequently found among MDS patients without clinical manifestation of AD. In a subset of patients, MDS and resulting cytopenias appear to be the consequence of auto reactive immunologic activity and may respond to immunosuppressive treatment (IST). Increased release of inflammatory cytokines like tumor necrosis factor-(TNF)-α and interferon (IF)-γ triggers apoptosis of myeloid precursor cells leading to cytopenias. Impaired function of immune cells including cytotoxic, regulatory (Treg), helper (Th17) T cells and NK cells also appears to predict response to IST, outcome and occurrence of AD. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Human striatal recordings reveal abnormal discharge of projection neurons in Parkinson's disease.

    Science.gov (United States)

    Singh, Arun; Mewes, Klaus; Gross, Robert E; DeLong, Mahlon R; Obeso, José A; Papa, Stella M

    2016-08-23

    Circuitry models of Parkinson's disease (PD) are based on striatal dopamine loss and aberrant striatal inputs into the basal ganglia network. However, extrastriatal mechanisms have increasingly been the focus of attention, whereas the status of striatal discharges in the parkinsonian human brain remains conjectural. We now report the activity pattern of striatal projection neurons (SPNs) in patients with PD undergoing deep brain stimulation surgery, compared with patients with essential tremor (ET) and isolated dystonia (ID). The SPN activity in ET was very low (2.1 ± 0.1 Hz) and reminiscent of that found in normal animals. In contrast, SPNs in PD fired at much higher frequency (30.2 ± 1.2 Hz) and with abundant spike bursts. The difference between PD and ET was reproduced between 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-treated and normal nonhuman primates. The SPN activity was also increased in ID, but to a lower level compared with the hyperactivity observed in PD. These results provide direct evidence that the striatum contributes significantly altered signals to the network in patients with PD.

  6. Inhibition of WNT signaling in the bone marrow niche prevents the development of MDS in the Apcdel/+ MDS mouse model.

    Science.gov (United States)

    Stoddart, Angela; Wang, Jianghong; Hu, Chunmei; Fernald, Anthony A; Davis, Elizabeth M; Cheng, Jason X; Le Beau, Michelle M

    2017-06-01

    There is accumulating evidence that functional alteration(s) of the bone marrow (BM) microenvironment contribute to the development of some myeloid disorders, such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). In addition to a cell-intrinsic role of WNT activation in leukemia stem cells, WNT activation in the BM niche is also thought to contribute to the pathogenesis of MDS and AML. We previously showed that the Apc -haploinsufficient mice ( Apc del/+ ) model MDS induced by an aberrant BM microenvironment. We sought to determine whether Apc, a multifunctional protein and key negative regulator of the canonical β-catenin (Ctnnb1)/WNT-signaling pathway, mediates this disease through modulating WNT signaling, and whether inhibition of WNT signaling prevents the development of MDS in Apc del/+ mice. Here, we demonstrate that loss of 1 copy of Ctnnb1 is sufficient to prevent the development of MDS in Apc del/+ mice and that altered canonical WNT signaling in the microenvironment is responsible for the disease. Furthermore, the US Food and Drug Administration (FDA)-approved drug pyrvinium delays and/or inhibits disease in Apc del /+ mice, even when it is administered after the presentation of anemia. Other groups have observed increased nuclear CTNNB1 in stromal cells from a high frequency of MDS/AML patients, a finding that together with our results highlights a potential new strategy for treating some myeloid disorders. © 2017 by The American Society of Hematology.

  7. Discharge processes, electric field, and electron energy in ISUAL-recorded gigantic jets

    Science.gov (United States)

    Kuo, Cheng-Ling; Chou, J. K.; Tsai, L. Y.; Chen, A. B.; Su, H. T.; Hsu, R. R.; Cummer, S. A.; Frey, H. U.; Mende, S. B.; Takahashi, Y.; Lee, L. C.

    2009-04-01

    This article reports the first high time resolution measurements of gigantic jets from the Imager of Sprites and Upper Atmospheric Lightning (ISUAL) experiment. The velocity of the upward propagating fully developed jet stage of the gigantic jets was ˜107 m s-1, which is similar to that observed for downward sprite streamers. Analysis of spectral ratios for the fully developed jet emissions gives a reduced E field of 400-655 Td and average electron energy of 8.5-12.3 eV. These values are higher than those in the sprites but are similar to those predicted by streamer models, which implies the existence of streamer tips in fully developed jets. The gigantic jets studied here all contained two distinct photometric peaks. The first peak is from the fully developed jet, which steadily propagates from the cloud top (˜20 km) to the lower ionosphere at ˜90 km. We suggest that the second photometric peak, which occurs ˜1 ms after the first peak, is from a current wave or potential wave-enhanced emissions that originate at an altitude of ˜50 km and extend toward the cloud top. We propose that the fully developed jet serves as an extension of the local ionosphere and produces a lowered ionosphere boundary. As the attachment processes remove the charges, the boundary of the local ionosphere moves up. The current in the channel persists and its contact point with the ionosphere moves upward, which produces the upward surging trailing jets. Imager and photometer data indicate that the lightning activity associated with the gigantic jets likely is in-cloud, and thus the initiation of the gigantic jets is not directly associated with cloud-to-ground discharges.

  8. Cytomorphology review of 100 newly diagnosed lower-risk MDS patients in the European LeukemiaNet MDS (EUMDS) registry reveals a high inter-observer concordance

    NARCIS (Netherlands)

    Swart, L. de; Smith, A.; MacKenzie, M.; Symeonidis, A.; Neukirchen, J.; Mikulenkova, D.; Vallespi, T.; Zini, G.; Paszkowska-Kowalewska, M.; Kruger, A.; Saft, L.; Fenaux, P.; Bowen, D.; Hellstrom-Lindberg, E.; Cermak, J.; Stauder, R.; Tatic, A.; Holm, M.S.; Malcovati, L.; Madry, K.; Droste, J.A.; Blijlevens, N.M.; Witte, T.J. de; Germing, U.

    2017-01-01

    The European LeukemiaNet MDS (EUMDS) registry is collecting data of myelodysplastic syndrome (MDS) patients belonging to the IPSS low or intermediate-1 category, newly diagnosed by local cytologists. The diagnosis of MDS can be challenging, and some data report inter-observer variability with regard

  9. Angina - discharge

    Science.gov (United States)

    Chest pain - discharge; Stable angina - discharge; Chronic angina - discharge; Variant angina - discharge; Angina pectoris - discharge; Accelerating angina - discharge; New-onset angina - discharge; Angina-unstable - discharge; ...

  10. PD-1 signaling and inhibition in AML and MDS.

    Science.gov (United States)

    Haroun, Faysal; Solola, Sade A; Nassereddine, Samah; Tabbara, Imad

    2017-09-01

    Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are clinically and molecularly heterogeneous clonal myeloid disorders with a poor prognosis especially in the relapsed refractory setting and in patients above the age of 60. While allogeneic hematopoietic stem cell transplantation (ASCT) is a potentially curative approach, high relapse, morbidity, and mortality rates necessitate the development of alternative therapies. Immune checkpoint inhibitors unmask tumoral immune tolerance and have demonstrated efficacy in the treatment of chemotherapy-resistant hematologic and solid malignancies. The rationale for the investigation of those agents in AML and MDS is supported by an observed increased expression of programmed cell death 1 protein (PD-1) and ligand 1 (PD-L1) in the hematopoietic microenvironment of AML and MDS, and its association with low TP53 and a poor prognosis. Early clinical experience in combination with a hypomethylating agent has shown encouraging responses; however, larger clinical trials are needed to determine the role of checkpoint inhibition in myeloid malignancies.

  11. Monitoring the grid with the Globus Toolkit MDS4

    International Nuclear Information System (INIS)

    Schopf, Jennifer M; Pearlman, Laura; Miller, Neill; Kesselman, Carl; Foster, Ian; D'Arcy, Mike; Chervenak, Ann

    2006-01-01

    The Globus Toolkit Monitoring and Discovery System (MDS4) defines and implements mechanisms for service and resource discovery and monitoring in distributed environments. MDS4 is distinguished from previous similar systems by its extensive use of interfaces and behaviors defined in the WS-Resource Framework and WS-Notification specifications, and by its deep integration into essentially every component of the Globus Toolkit. We describe the MDS4 architecture and the Web service interfaces and behaviors that allow users to discover resources and services, monitor resource and service states, receive updates on current status, and visualize monitoring results. We present two current deployments to provide insights into the functionality that can be achieved via the use of these mechanisms

  12. The MDS challenging behavior profile for long-term care

    NARCIS (Netherlands)

    Gerritsen, D. L.; Achterberg, W. P.; Steverink, N.; Frijters, D. H. M.; Ribbe, M. W.

    2008-01-01

    The objective was to construct a reliable and valid challenging behavior scale with items from the Minimum Data Set (MDS). Exploratory factor analyses of a sample of 656 nursing home residents yielded a 16-item Behavior Profile containing four internally consistent and valid subscales measuring

  13. Interaction mediated by the putative tip regions of MdsA and MdsC in the formation of a Salmonella-specific tripartite efflux pump.

    Directory of Open Access Journals (Sweden)

    Saemee Song

    Full Text Available To survive in the presence of a wide range of toxic compounds, gram-negative bacteria expel such compounds via tripartite efflux pumps that span both the inner and outer membranes. The Salmonella-specific MdsAB pump consists of MdsB, a resistance-nodulation-division (RND-type inner membrane transporter (IMT that requires the membrane fusion protein (MFP MdsA, and an outer membrane protein (OMP; MdsC or TolC to form a tripartite efflux complex. In this study, we investigated the role of the putative tip regions of MdsA and its OMPs, MdsC and TolC, in the formation of a functional MdsAB-mediated efflux pump. Comparative analysis indicated that although sequence homologies of MdsA and MdsC with other MFPs and OMPs, respectively, are extremely low, key residues in the putative tip regions of these proteins are well conserved. Mutagenesis studies on these conserved sites demonstrated their importance for the physical and functional interactions required to form an MdsAB-mediated pump. Our studies suggest that, despite differences in the primary amino acid sequences and functions of various OMPs and MFPs, interactions mediated by the conserved tip regions of OMP and MFP are required for the formation of functional tripartite efflux pumps in gram-negative bacteria.

  14. Handling missing values in the MDS-UPDRS.

    Science.gov (United States)

    Goetz, Christopher G; Luo, Sheng; Wang, Lu; Tilley, Barbara C; LaPelle, Nancy R; Stebbins, Glenn T

    2015-10-01

    This study was undertaken to define the number of missing values permissible to render valid total scores for each Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part. To handle missing values, imputation strategies serve as guidelines to reject an incomplete rating or create a surrogate score. We tested a rigorous, scale-specific, data-based approach to handling missing values for the MDS-UPDRS. From two large MDS-UPDRS datasets, we sequentially deleted item scores, either consistently (same items) or randomly (different items) across all subjects. Lin's Concordance Correlation Coefficient (CCC) compared scores calculated without missing values with prorated scores based on sequentially increasing missing values. The maximal number of missing values retaining a CCC greater than 0.95 determined the threshold for rendering a valid prorated score. A second confirmatory sample was selected from the MDS-UPDRS international translation program. To provide valid part scores applicable across all Hoehn and Yahr (H&Y) stages when the same items are consistently missing, one missing item from Part I, one from Part II, three from Part III, but none from Part IV can be allowed. To provide valid part scores applicable across all H&Y stages when random item entries are missing, one missing item from Part I, two from Part II, seven from Part III, but none from Part IV can be allowed. All cutoff values were confirmed in the validation sample. These analyses are useful for constructing valid surrogate part scores for MDS-UPDRS when missing items fall within the identified threshold and give scientific justification for rejecting partially completed ratings that fall below the threshold. © 2015 International Parkinson and Movement Disorder Society.

  15. Record linkage between hospital discharges and mortality registries for motor neuron disease case ascertainment for the Spanish National Rare Diseases Registry.

    Science.gov (United States)

    Ruiz, Elena; Ramalle-Gómara, Enrique; Quiñones, Carmen

    2014-06-01

    Our objective was to analyse the coverage of hospital discharge data and the mortality registry (MR) of La Rioja to ascertain motor neuron disease (MND) cases to be included in the Spanish National Rare Diseases Registry. MND cases that occurred in La Rioja during the period 1996-2011 were selected from hospital discharge data and the MR by means of the International Classification of Diseases. Review of the medical histories was carried out to confirm the causes of death reported. Characteristics of the population with MND were analysed. A total of 133 patients with MND were detected in La Rioja during the period 1996-2011; 30.1% were only recorded in the hospital discharges data, 12.0% only in the MR, and 57.9% were recorded by both databases. Medical records revealed a miscoding of patients who had been diagnosed with progressive supranuclear palsy but were recorded in the MR with an MND code. In conclusion, the hospital discharges data and the MR appear to be complementary and are valuable databases for the Spanish National Rare Diseases Registry when MNDs are properly codified. Nevertheless, it would be advisable to corroborate the validity of the MR as data source since the miscoding of progressive supranuclear palsy has been corrected.

  16. Despite differential gene expression profiles pediatric MDS derived mesenchymal stromal cells display functionality in vitro.

    Science.gov (United States)

    Calkoen, F G J; Vervat, C; van Pel, M; de Haas, V; Vijfhuizen, L S; Eising, E; Kroes, W G M; 't Hoen, P A C; van den Heuvel-Eibrink, M M; Egeler, R M; van Tol, M J D; Ball, L M

    2015-03-01

    Pediatric myelodysplastic syndrome (MDS) is a heterogeneous disease covering a spectrum ranging from aplasia (RCC) to myeloproliferation (RAEB(t)). In adult-type MDS there is increasing evidence for abnormal function of the bone-marrow microenvironment. Here, we extensively studied the mesenchymal stromal cells (MSCs) derived from children with MDS. MSCs were expanded from the bone-marrow of 17 MDS patients (RCC: n=10 and advanced MDS: n=7) and pediatric controls (n=10). No differences were observed with respect to phenotype, differentiation capacity, immunomodulatory capacity or hematopoietic support. mRNA expression analysis by Deep-SAGE revealed increased IL-6 expression in RCC- and RAEB(t)-MDS. RCC-MDS MSC expressed increased levels of DKK3, a protein associated with decreased apoptosis. RAEB(t)-MDS revealed increased CRLF1 and decreased DAPK1 expressions. This pattern has been associated with transformation in hematopoietic malignancies. Genes reported to be differentially expressed in adult MDS-MSC did not differ between MSC of pediatric MDS and controls. An altered mRNA expression profile, associated with cell survival and malignant transformation, of MSC derived from children with MDS strengthens the hypothesis that the micro-environment is of importance in this disease. Our data support the understanding that pediatric and adult MDS are two different diseases. Further evaluation of the pathways involved might reveal additional therapy targets. Copyright © 2015. Published by Elsevier B.V.

  17. 75 FR 16512 - Willstaff Staffing Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., Working...

    Science.gov (United States)

    2010-04-01

    ... Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., Working On-Site at Tyler Pipe... MDS Industrial Resources, Inc., working on-site at Tyler Pipe Company, Waterworks Division, South... Staffing Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., working on-site at Tyler Pipe...

  18. Some Families of Asymmetric Quantum MDS Codes Constructed from Constacyclic Codes

    Science.gov (United States)

    Huang, Yuanyuan; Chen, Jianzhang; Feng, Chunhui; Chen, Riqing

    2018-02-01

    Quantum maximal-distance-separable (MDS) codes that satisfy quantum Singleton bound with different lengths have been constructed by some researchers. In this paper, seven families of asymmetric quantum MDS codes are constructed by using constacyclic codes. We weaken the case of Hermitian-dual containing codes that can be applied to construct asymmetric quantum MDS codes with parameters [[n,k,dz/dx

  19. An Integration of Ground-Penetrating Radar, Remote Sensing, and Discharge Records of the Modern Kicking Horse River, BC

    Science.gov (United States)

    Cyples, N.; Ielpi, A.; Dirszowsky, R.

    2017-12-01

    The Kicking Horse River is a gravel-bed stream originating from glacial meltwater supplied by the Wapta Icefields in south-eastern British Columbia. An alluvial tract extends for 7 km through Field, BC, where the trunk channel undergoes diurnal and seasonal fluctuations in flow as a result of varying glacial-meltwater supply and runoff recharge. Prior studies erected the Kicking Horse River as a reference for proximal braided systems, and documented bar formation and sediment distribution patterns from ground observations. However, a consistent model of planform evolution and related stratigraphic signature is lacking. Specific objectives of this study are to examine the morphodynamic evolution and stratigraphic signature of channel-bar complexes using high-resolution satellite imagery, sedimentologic and discharge observations, and ground-penetrating radar (GPR). Remote sensing highlights rates of lateral channel migration of as much as 270 meters over eight years ( 34 meters/year), and demonstrates how flood stages are associated with stepwise episodes of channel braiding and anabranching. GPR analysis aided in the identification of five distinct radar facies, including: discontinuous, inclined, planar, trough-shaped, and mounded reflectors, which were respectively related to specific architectural elements and fluvial processes responsible for bar evolution. Across-stream GPR transects demonstrated higher heterogeneity in facies distribution, while downstream-oriented transects yielded a more monotonous distribution in radar facies. Notably, large-scale inclined reflectors related to step-wise bar accretion are depicted only in downstream-oriented transects, while discontinuous reflectors related to bedform stacking appear to be dominant in along-stream transects. Integration of sedimentological data with remote sensing, gauging records, and GPR analysis allows for high-resolution modelling of stepwise changes in alluvial morphology. Conceptual models stemming

  20. New Insights into the Pathogenesis of MDS and the rational therapeutic opportunities.

    Science.gov (United States)

    Abou Zahr, Abdallah; Bernabe Ramirez, Carolina; Wozney, Jocelyn; Prebet, Thomas; Zeidan, Amer M

    2016-01-01

    Myelodysplastic syndromes (MDS) include a heterogeneous group of acquired hematopoietic malignancies characterized by ineffective hematopoiesis, peripheral cytopenias, and a varying propensity for progression to acute myeloid leukemia. The clinical heterogeneity in MDS is a reflection of its molecular heterogeneity. Better understanding of aberrant epigenetics, dysregulation of immune responses, and del(5q) MDS has provided the rationale for well-established treatments in MDS. Further understanding of abnormal signal transduction and aberrant apoptosis pathways has led to development of new rational therapies that are in advanced phases of clinical translation. This review seeks to describe recent developments in our understanding of the pathogenesis of MDS and the potential therapeutic implications of these observations.

  1. Entanglement-assisted quantum MDS codes from negacyclic codes

    Science.gov (United States)

    Lu, Liangdong; Li, Ruihu; Guo, Luobin; Ma, Yuena; Liu, Yang

    2018-03-01

    The entanglement-assisted formalism generalizes the standard stabilizer formalism, which can transform arbitrary classical linear codes into entanglement-assisted quantum error-correcting codes (EAQECCs) by using pre-shared entanglement between the sender and the receiver. In this work, we construct six classes of q-ary entanglement-assisted quantum MDS (EAQMDS) codes based on classical negacyclic MDS codes by exploiting two or more pre-shared maximally entangled states. We show that two of these six classes q-ary EAQMDS have minimum distance more larger than q+1. Most of these q-ary EAQMDS codes are new in the sense that their parameters are not covered by the codes available in the literature.

  2. The need for additional genetic markers for MDS stratification: what does the future hold for prognostication?

    Science.gov (United States)

    Otrock, Zaher K.; Tiu, Ramon V.; Maciejewski, Jaroslaw P.; Sekeres, Mikkael A.

    2013-01-01

    Myelodysplastic syndromes (MDS) constitute a heterogeneous group of clonal hematopoietic disorders. Metaphase cytogenetics (MC) has been the gold standard for genetic testing in MDS, but it can detect clonal cytogenetic abnormalities in only 50% of cases. New karyotyping tests include fluorescence in situ hybridization (FISH), array-based comparative genomic hybridization (aCGH), and single nucleotide polymorphism arrays (SNP-A). These techniques have increased the detected genetic abnormalities in MDS, many of which confer prognostic significance to overall and leukemia-free survival. This has eventually increased our understanding of MDS genetics. With the help of new technologies, we anticipate that the existing prognostic scoring systems will incorporate mutational data into their parameters. This review discusses the progress in MDS diagnosis through the use of array-based technologies. We also discuss the recently investigated genetic mutation in MDS, and revisit the MDS classification and prognostic scoring systems. PMID:23373781

  3. Genetic predisposition syndromes: when should they be considered in the work-up of MDS?

    Science.gov (United States)

    Babushok, Daria V; Bessler, Monica

    2015-03-01

    Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by cytopenias, ineffective hematopoiesis, myelodysplasia, and an increased risk of acute myeloid leukemia (AML). While sporadic MDS is primarily a disease of the elderly, MDS in children and young and middle-aged adults is frequently associated with underlying genetic predisposition syndromes. In addition to the classic hereditary bone marrow failure syndromes (BMFS) such as Fanconi Anemia and Dyskeratosis Congenita, in recent years there has been an increased awareness of non-syndromic familial MDS/AML predisposition syndromes such as those caused by mutations in GATA2, RUNX1, CEBPA, and SRP72 genes. Here, we will discuss the importance of recognizing an underlying genetic predisposition syndrome a patient with MDS, will review clinical scenarios when genetic predisposition should be considered, and will provide a practical overview of the common BMFS and familial MDS/AML syndromes which may be encountered in adult patients with MDS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. To chelate or not to chelate in MDS: That is the question!

    Science.gov (United States)

    Zeidan, Amer M; Griffiths, Elizabeth A

    2018-03-08

    Myelodysplastic syndromes (MDS) are a heterogeneous group of hemopathies that exhibit physical manifestations with clinical consequences of bone marrow failure and inherent risk of progression to acute myeloid leukemia. Iron overload (IO) is common in MDS due to chronic transfusion support and disease-related alterations in iron metabolism. IO has been conclusively associated with inferior outcomes among MDS patients. Despite lack of randomized trials showing a survival impact of iron chelation therapy (ICT), ICT is recommended by experts and guidelines for select MDS patients with IO and is often used. The availability of effective oral ICT agents has reignited the controversy regarding ICT use in patients with MDS and IO. Here we summarize the studies evaluating the value of ICT in MDS and suggest a practical approach for use of these therapies. We also highlight controversies regarding use of ICT in MDS and discuss some ongoing efforts to answer these questions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. Clinical Features and Outcomes of 666 Cases with Therapy-Related Myelodysplastic Syndrome (t-MDS).

    Science.gov (United States)

    El-Fattah, Mohamed Abd

    2018-01-01

    Therapy-related myelodysplastic syndrome (t-MDS) is a serious complication of chemoradiotherapy for primary diseases. This cohort was aimed to determine the clinical features and outcomes of t-MDS in comparison with de novo MDS. I retrieved data of 666 cases with t-MDS, and 29,703 cases with de novo MDS diagnosed between 2001 and 2012 from the database of U.S. National Cancer Institute. Survival curves were estimated, and Cox proportional hazards model was constructed. Compared with patients with de novo MDS, patients with t-MDS tended to be young (median age; 65 vs. 76 years, p  MDS than de novo MDS (17.2 months and 22% vs. 31 months and 32%, respectively, p  MDS cases, with a median follow-up of 16 months (range 1-143 months), 521 cases (78.2%) had died. Of which, 78 (15%) cases had died from acute myeloid leukemia, and 66 (12.7%) cases had died from solid cancers. Of the total 66 cases died from solid cancers; 19 cases (28.8%) died from cancer of lung/bronchus, 11 cases (16.7%) breast cancers, and 10 cases (15.2%) ovarian cancer. In a multivariate analysis adjusted for clinical features, calendar period and radiotherapy, the hazard of mortality was significantly low in de novo MDS compared with t-MDS (hazard ratio 0.59; p  MDS is a distinct entity of MDS in terms of clinical characteristics and prognosis.

  6. Inadequate recording of alcohol-drinking, tobacco-smoking and discharge diagnosis in medical in-patients: failure to recognize risks including drug interactions.

    Science.gov (United States)

    Bairstow, B M; Burke, V; Beilin, L J; Deutscher, C

    1993-11-01

    The records of 62 men and 43 women, 14-88 years old, admitted to general medical wards in a public teaching hospital during 1991 were examined for discharge medications and for the recording of alcohol-drinking, tobacco-smoking and discharge diagnosis. Drinking and smoking status was unrecorded in 22.9% and 21.9% of patients respectively. Twenty-four patients had 31 potential drug interactions which were related to the number of drugs prescribed and to drinking alcohol; 10.5% of the patients had interactions involving alcohol and 2.9% tobacco. Six patients received relatively or absolutely contraindicated drugs, including one asthmatic given two beta-blockers. The drugs prescribed indicated that some patients had conditions such as gastro-oesophageal disorders, diabetes and obstructive airways disease which had not been recorded. Inadequate recording of diagnoses, alcohol and smoking status creates risks to patients and may cause opportunities for preventive care to be missed. This study provides the basis for the development of undergraduate and postgraduate education programmes to address these issues and so decrease risks to patients which arise from inadequate recording practices. Incomplete diagnoses also adversely affect hospital funding where this depends on case-mix diagnostic groups. Quality assurance programmes and other strategies are being implemented to improve medical recording and prescribing habits.

  7. Age-related epigenetic drift in the pathogenesis of MDS and AML.

    Science.gov (United States)

    Maegawa, Shinji; Gough, Sheryl M; Watanabe-Okochi, Naoko; Lu, Yue; Zhang, Nianxiang; Castoro, Ryan J; Estecio, Marcos R H; Jelinek, Jaroslav; Liang, Shoudan; Kitamura, Toshio; Aplan, Peter D; Issa, Jean-Pierre J

    2014-04-01

    The myelodysplastic syndrome (MDS) is a clonal hematologic disorder that frequently evolves to acute myeloid leukemia (AML). Its pathogenesis remains unclear, but mutations in epigenetic modifiers are common and the disease often responds to DNA methylation inhibitors. We analyzed DNA methylation in the bone marrow and spleen in two mouse models of MDS/AML, the NUP98-HOXD13 (NHD13) mouse and the RUNX1 mutant mouse model. Methylation array analysis showed an average of 512/3445 (14.9%) genes hypermethylated in NHD13 MDS, and 331 (9.6%) genes hypermethylated in RUNX1 MDS. Thirty-two percent of genes in common between the two models (2/3 NHD13 mice and 2/3 RUNX1 mice) were also hypermethylated in at least two of 19 human MDS samples. Detailed analysis of 41 genes in mice showed progressive drift in DNA methylation from young to old normal bone marrow and spleen; to MDS, where we detected accelerated age-related methylation; and finally to AML, which markedly extends DNA methylation abnormalities. Most of these genes showed similar patterns in human MDS and AML. Repeat element hypomethylation was rare in MDS but marked the transition to AML in some cases. Our data show consistency in patterns of aberrant DNA methylation in human and mouse MDS and suggest that epigenetically, MDS displays an accelerated aging phenotype.

  8. Methods for estimating annual exceedance-probability discharges and largest recorded floods for unregulated streams in rural Missouri.

    Science.gov (United States)

    2014-01-01

    Regression analysis techniques were used to develop a : set of equations for rural ungaged stream sites for estimating : discharges with 50-, 20-, 10-, 4-, 2-, 1-, 0.5-, and 0.2-percent : annual exceedance probabilities, which are equivalent to : ann...

  9. The Mice Drawer System Tissue Sharing Program (MDS-TSP)

    Science.gov (United States)

    Biticchi, Roberta; Cancedda, Ranieri; Cilli, Michele; Cotronei, Vittorio; Costa, Delfina; Liu, Yi; Piccardi, Federica; Pignataro, Salvatore; Ruggiu, Alessandra; Tasso, Roberta; Tavella, Sara

    Several organs and apparatus are affected by weightless conditions and in particular by the weightless experienced during space flights. Therefore space missions are good opportunities to investigate in a whole organism the controlling cellular and molecular mechanisms. For this type of studies mice represent an excellent animal model for several reasons: reduced body size, relatively short time needed to reach adulthood, availability of strains with different genetic background and of different transgenic lines, etc. In line with the International Space Station (ISS) development, the Italian Space Agency (ASI) contracted Thales Alenia Space Italia, the largest Italian aerospace industry, to design and build a spaceflight payload for rodent research on ISS, the Mouse Drawer System (MDS -see abstract P. Cipparelli et al.). This payload meets NIH guideline for several physical parameters to maintain 6 animals in good health conditions in a space environment. Given the interest of our laboratory in the microgravity induced skeleton alterations, we focused our attention on transgenic mice over-expressing pleiotrophin (PTN) under the control of the human bone specific osteocalcin promoter. This protein is a heparin-binding cytokine with different functions. PTN is expressed by the cells in an early differentiation stage and is upregulated in tissue injury and wound repair. PTN is specifically involved in bone formation, neurite outgrowth and angiogenesis. As PTN-transgenic mice show an increased bone mass and mineralization, we decided to use this mouse model in the flight experiment and to study its potential role in counteracting bone loss in microgravity. Not all mouse strains are equally suitable for flight. After preliminary tests in the MDS breadboard at our animal facility on the behavior of different mouse strains, PTN-transgenic mice originally obtained in the BDF strain were backcrossed in the C57Bl/J10 strain before being used in this study. In order to

  10. Cost of transfusion-dependent myelodysplastic syndrome (MDS) from a German payer?s perspective

    OpenAIRE

    2010-01-01

    Abstract No curative treatment exists for patients with myelodysplastic syndrome (MDS) besides allogeneic stem cell transplantation. Hence, palliative treatment is provided for a life time accruing high health care cost. As no study in cost of MDS exists in Germany, the objective of this study was to assess and analyze costs of transfusion-dependent low/intermediate-1-risk MDS in Germany from a payers? perspective. From seven centers, 116 low/intermediate-1-risk transfusion-depende...

  11. Research in karst aquifers developed in high-mountain areas combining KARSYS models with springs discharge records. Picos de Europa, Spain

    Science.gov (United States)

    Ballesteros, Daniel; Meléndez, Mónica; Malard, Arnauld; Jiménez-Sánchez, Montserrat; Heredia, Nemesio; Jeannin, Pierre-Yves; García-Sansegundo, Joaquín

    2014-05-01

    The study of karst aquifers developed in high-mountain areas is quite complex since the application of many techniques of hydrogeology in these areas is difficult, expensive, and requires many hours of field work. In addition, the access to the study area is usually conditioned by the orography and the meteorological conditions. A pragmatic approach to study these aquifers can be the combination of geometric models of the aquifer with the monitoring of the discharge rate of springs and the meteorological records. KARSYS approach (Jeannin et al. 2013) allows us to elaborate a geometric model of karst aquifers establishing the boundaries of the groundwater bodies, the main drainage axes and providing evidences of the catchment delineation of the springs. The aim of this work is to analyse the functioning of the karst aquifer from the western and central part of the Picos de Europa Mountains (Spain) combining the KARSYS approach, the discharge record from two springs and the meteorological records (rain, snow and temperature). The Picos de Europa (North Spain) is a high-mountains area up to 2.6 km altitude with 2,500 mm/year of precipitations. The highest part of these mountains is covered by snow four to seven months a year. The karst aquifer is developed in Carboniferous limestone which is strongly compartmentalized in, at least, 17 groundwater bodies. The method of work includes: 1) the elaboration of a hydrogeological 3D model of the geometry of the karst aquifers by KARSYS approach, 2) the definition of the springs catchment areas based on the hydrogeological 3D model, 3) the selection of two representative springs emerging from the aquifers to study it, 4) the continuous monitoring of water levels in two karst springs since October 2013, 5) the transformation of the water level values to flow values using height-stream relation curves constructed by measures of the spring discharge, and 5) the comparison of the spring discharge rate records and meteorological

  12. Riverine discharges to Chesapeake Bay: Analysis of long-term (1927–2014) records and implications for future flows in the Chesapeake Bay basin

    Science.gov (United States)

    Rice, Karen; Moyer, Douglas; Mills, Aaron L.

    2017-01-01

    The Chesapeake Bay (CB) basin is under a total maximum daily load (TMDL) mandate to reduce nitrogen, phosphorus, and sediment loads to the bay. Identifying shifts in the hydro-climatic regime may help explain observed trends in water quality. To identify potential shifts, hydrologic data (1927–2014) for 27 watersheds in the CB basin were analyzed to determine the relationships among long-term precipitation and stream discharge trends. The amount, frequency, and intensity of precipitation increased from 1910 to 1996 in the eastern U.S., with the observed increases greater in the northeastern U.S. than the southeastern U.S. The CB watershed spans the north-to-south gradient in precipitation increases, and hydrologic differences have been observed in watersheds north relative to watersheds south of the Pennsylvania—Maryland (PA-MD) border. Time series of monthly mean precipitation data specific to each of 27 watersheds were derived from the Precipitation-elevation Regression on Independent Slopes Model (PRISM) dataset, and monthly mean stream-discharge data were obtained from U.S. Geological Survey streamgage records. All annual precipitation trend slopes in the 18 watersheds north of the PA-MD border were greater than or equal to those of the nine south of that border. The magnitude of the trend slopes for 1927–2014 in both precipitation and discharge decreased in a north-to-south pattern. Distributions of the monthly precipitation and discharge datasets were assembled into percentiles for each year for each watershed. Multivariate correlation of precipitation and discharge within percentiles among the groups of northern and southern watersheds indicated only weak associations. Regional-scale average behaviors of trends in the distribution of precipitation and discharge annual percentiles differed between the northern and southern watersheds. In general, the linkage between precipitation and discharge was weak, with the linkage weaker in the northern watersheds

  13. Insufficient stromal support in MDS results from molecular and functional deficits of mesenchymal stromal cells.

    Science.gov (United States)

    Geyh, S; Oz, S; Cadeddu, R-P; Fröbel, J; Brückner, B; Kündgen, A; Fenk, R; Bruns, I; Zilkens, C; Hermsen, D; Gattermann, N; Kobbe, G; Germing, U; Lyko, F; Haas, R; Schroeder, T

    2013-09-01

    Ineffective hematopoiesis is a major characteristic of myelodysplastic syndromes (MDS) causing relevant morbidity and mortality. Mesenchymal stromal cells (MSC) have been shown to physiologically support hematopoiesis, but their contribution to the pathogenesis of MDS remains elusive. We show that MSC from patients across all MDS subtypes (n=106) exhibit significantly reduced growth and proliferative capacities accompanied by premature replicative senescence. Osteogenic differentiation was significantly reduced in MDS-derived MSC, indicated by cytochemical stainings and reduced expressions of Osterix and Osteocalcin. This was associated with specific methylation patterns that clearly separated MDS-MSC from healthy controls and showed a strong enrichment for biological processes associated with cellular phenotypes and transcriptional regulation. Furthermore, in MDS-MSC, we detected altered expression of key molecules involved in the interaction with hematopoietic stem and progenitor cells (HSPC), in particular Osteopontin, Jagged1, Kit-ligand and Angiopoietin as well as several chemokines. Functionally, this translated into a significantly diminished ability of MDS-derived MSC to support CD34+ HSPC in long-term culture-initiating cell assays associated with a reduced cell cycle activity. Taken together, our comprehensive analysis shows that MSC from all MDS subtypes are structurally, epigenetically and functionally altered, which leads to impaired stromal support and seems to contribute to deficient hematopoiesis in MDS.

  14. Utility of 5-Methylcytosine Immunohistochemical Staining to Assess Global DNA Methylation and Its Prognostic Impact in MDS Patients

    Science.gov (United States)

    Chandra, Dinesh; Tyagi, Seema; Singh, Jasdeep; Deka, Roopam; Manivannan, Prabhu; Mishra, Pravas; Pati, Hara Prasad; Saxena, Renu

    2017-12-29

    Background: DNA methylation plays a vital role in the pathogenesis of the myelodysplastic syndrome (MDS), a heterogeneous group of clonal hematopoietic stem cell (HSC) disorders. It is reported to be an independent prognostic factor affecting overall survival (OS). Our aim was to analyze the role of global DNA methylation using an anti-5-methylcytosine (5-MC) antibody by immunohistochemistry (IHC) of bone marrow biopsy (BM Bx) specimens in MDS patients, assessing correlations with various clinical and biological prognostic factors. Material and methods: A total of 59 MDS cases, classified as per the World Health Organization (WHO) 2008 guidelines, were evaluated over a period of 4 years. Clinical data were retrieved from departmental case records and anti-5-MC expression was analyzed with formalin fixed paraffin embedded sections of BM Bx specimens of MDS patients and controls. Results: The median age at diagnosis was 52 years (15-85years). Patients were categorized into low risk (59%) and high risk (41%) according to International Prognostic Scoring System (IPSS). The median follow-up time was 10 months (1 to 37 months). We generated a methylation score (M-score) using anti-5-MC and with the derived cut-off of 30.5 from the receiver operator curve (ROC), there was a significant difference between the two groups in the percentage of BM blasts (p=0.01), WHO sub-type (p=0.01), IPSS (p=0.004), progression to AML (p=0.04) on univariate analysis. Interestingly, patients showing a high M-score (M-score ≥ 30.5) demonstrated a significantly shorter OS and progression to AML. However, on multivariate analysis, only BM blasts (p=0.01) and IPSS (p=0.02) remained independent variables for progression to AML and OS respectively. Conclusion: Immunostaining with anti-5-MC antibody with BM Bx samples is a simple and cost effective technique to detect global methylation, a powerful tool to predict overall survival in patients with MDS. Creative Commons Attribution License

  15. Measuring depression in nursing home residents with the MDS and GDS: an observational psychometric study

    Directory of Open Access Journals (Sweden)

    Fries Brant E

    2005-01-01

    Full Text Available Abstract Background The objective of this study was to examine the Minimum Data Set (MDS and Geriatric Depression Scale (GDS as measures of depression among nursing home residents. Methods The data for this study were baseline, pre-intervention assessment data from a research study involving nine nursing homes and 704 residents in Massachusetts. Trained research nurses assessed residents using the MDS and the GDS 15-item version. Demographic, psychiatric, and cognitive data were obtained using the MDS. Level of depression was operationalized as: (1 a sum of the MDS Depression items; (2 the MDS Depression Rating Scale; (3 the 15-item GDS; and (4 the five-item GDS. We compared missing data, floor effects, means, internal consistency reliability, scale score correlation, and ability to identify residents with conspicuous depression (chart diagnosis or use of antidepressant across cognitive impairment strata. Results The GDS and MDS Depression scales were uncorrelated. Nevertheless, both MDS and GDS measures demonstrated adequate internal consistency reliability. The MDS suggested greater depression among those with cognitive impairment, whereas the GDS suggested a more severe depression among those with better cognitive functioning. The GDS was limited by missing data; the DRS by a larger floor effect. The DRS was more strongly correlated with conspicuous depression, but only among those with cognitive impairment. Conclusions The MDS Depression items and GDS identify different elements of depression. This may be due to differences in the manifest symptom content and/or the self-report nature of the GDS versus the observer-rated MDS. Our findings suggest that the GDS and the MDS are not interchangeable measures of depression.

  16. Measuring depression in nursing home residents with the MDS and GDS: an observational psychometric study

    Science.gov (United States)

    Koehler, Melissa; Rabinowitz, Terry; Hirdes, John; Stones, Michael; Carpenter, G Iain; Fries, Brant E; Morris, John N; Jones, Richard N

    2005-01-01

    Background The objective of this study was to examine the Minimum Data Set (MDS) and Geriatric Depression Scale (GDS) as measures of depression among nursing home residents. Methods The data for this study were baseline, pre-intervention assessment data from a research study involving nine nursing homes and 704 residents in Massachusetts. Trained research nurses assessed residents using the MDS and the GDS 15-item version. Demographic, psychiatric, and cognitive data were obtained using the MDS. Level of depression was operationalized as: (1) a sum of the MDS Depression items; (2) the MDS Depression Rating Scale; (3) the 15-item GDS; and (4) the five-item GDS. We compared missing data, floor effects, means, internal consistency reliability, scale score correlation, and ability to identify residents with conspicuous depression (chart diagnosis or use of antidepressant) across cognitive impairment strata. Results The GDS and MDS Depression scales were uncorrelated. Nevertheless, both MDS and GDS measures demonstrated adequate internal consistency reliability. The MDS suggested greater depression among those with cognitive impairment, whereas the GDS suggested a more severe depression among those with better cognitive functioning. The GDS was limited by missing data; the DRS by a larger floor effect. The DRS was more strongly correlated with conspicuous depression, but only among those with cognitive impairment. Conclusions The MDS Depression items and GDS identify different elements of depression. This may be due to differences in the manifest symptom content and/or the self-report nature of the GDS versus the observer-rated MDS. Our findings suggest that the GDS and the MDS are not interchangeable measures of depression. PMID:15627403

  17. Differential response to hypomethylating agents based on sex: a report on behalf of the MDS Clinical Research Consortium (MDS CRC).

    Science.gov (United States)

    DeZern, Amy E; Zeidan, Amer M; Barnard, John; Hand, Wesley; Al Ali, Najla; Brown, Francis; Zimmerman, Cassie; Roboz, Gail J; Garcia-Manero, Guillermo; Steensma, David P; Komrokji, Rami S; Sekeres, Mikkael A

    2017-06-01

    First-line therapy for higher-risk myelodysplastic syndromes (MDS) includes decitabine (DAC) or azacitidine (AZA). Variables have not identified differential response rates between these. We assessed the influence of patient sex on outcomes including overall survival (OS) in 642 patients with higher-risk MDS treated with AZA or DAC. DAC-treated patients (35% of females, 31% of males) had marginally better OS than AZA-treated patients (p = .043), (median OS of 18.7 months versus 16.4 months), but the difference varied strongly by sex. Female patients treated with DAC had a longer median OS (21.1 months, 95% CI: 16.0-28.0) than female patients treated with AZA (13.2 months, 95% CI: 11.0-15.9; p = .0014), while for males there was no significant difference between HMAs (median OS 18.3 months with DAC versus 17.9 months for AZA, p = .59). The biological reason for this variability is unclear, but may be a consequence of differences in cytidine deaminase activity between men and women.

  18. Maintenance treatment with azacytidine for patients with high-risk myelodysplastic syndromes (MDS) or acute myeloid leukaemia following MDS in complete remission after induction chemotherapy

    DEFF Research Database (Denmark)

    Grövdal, Michael; Karimi, Mohsen; Khan, Rasheed

    2010-01-01

    This prospective Phase II study is the first to assess the feasibility and efficacy of maintenance 5-azacytidine for older patients with high-risk myelodysplastic syndrome (MDS), chronic myelomonocytic leukaemia and MDS-acute myeloid leukaemia syndromes in complete remission (CR) after induction ......-IV thrombocytopenia and neutropenia occurred after 9.5 and 30% of the cycles, respectively, while haemoglobin levels increased during treatment. 5-azacytidine treatment is safe, feasible and may be of benefit in a subset of patients....

  19. Despite differential gene expression profiles pediatric MDS derived mesenchymal stromal cells display functionality in vitro

    Directory of Open Access Journals (Sweden)

    F.G.J. Calkoen

    2015-03-01

    An altered mRNA expression profile, associated with cell survival and malignant transformation, of MSC derived from children with MDS strengthens the hypothesis that the micro-environment is of importance in this disease. Our data support the understanding that pediatric and adult MDS are two different diseases. Further evaluation of the pathways involved might reveal additional therapy targets.

  20. TOPICS-MDS: Veelzijdige bron voor wetenschappelijke en maatschappelijke kennisgeneratie ten behoeve van de ouderenzorg

    NARCIS (Netherlands)

    van den Brink, D.; Lutomski, J.E.; Qin, L.; den Elzen, W.P.J.; Kempen, G.I.J.M.; Krabbe, P.F.M.; Steyerberg, E.W.; Muntinga, M.E.; Moll van Charante, E.P.; Bleijenberg, N.; Olde Rikkert, M.G.M.; Melis, R.J.F.

    2015-01-01

    Developed as part of the National Care for the Elderly Programme (NPO), TOPICS-MDS is a uniform, national database on the health and wellbeing of the older persons and caregivers who participated in NPO-funded projects. TOPICS-MDS Consortium has gained extensive experience in constructing a

  1. Minimal clinically important difference on the Motor Examination part of MDS-UPDRS.

    Science.gov (United States)

    Horváth, Krisztina; Aschermann, Zsuzsanna; Ács, Péter; Deli, Gabriella; Janszky, József; Komoly, Sámuel; Balázs, Éva; Takács, Katalin; Karádi, Kázmér; Kovács, Norbert

    2015-12-01

    Recent studies increasingly utilize the Movement Disorders Society Sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS). However, the minimal clinically important difference (MCID) has not been fully established for MDS-UPDRS yet. To assess the MCID thresholds for MDS-UPDRS Motor Examination (Part III). 728 paired investigations of 260 patients were included. At each visit both MDS-UPDRS and Clinician-reported Global Impression-Improvement (CGI-I) scales were assessed. MDS-UPDRS Motor Examination (ME) score changes associated with CGI-I score 4 (no change) were compared with MDS-UPDRS ME score changes associated with CGI-I score 3 (minimal improvement) and CGI-I score 5 (minimal worsening). Both anchor- and distribution-based techniques were utilized to determine the magnitude of MCID. The MCID estimates for MDS-UPDRS ME were asymmetric: -3.25 points for detecting minimal, but clinically pertinent, improvement and 4.63 points for observing minimal, but clinically pertinent, worsening. MCID is the smallest change of scores that are clinically meaningful to patients. These MCID estimates may allow the judgement of a numeric change in MDS-UPDRS ME on its clinical importance. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Apoptosis-Related Gene Expression Profiling in Hematopoietic Cell Fractions of MDS Patients

    NARCIS (Netherlands)

    MC Langemeijer, Saskia; Mariani, Niccolo; Knops, Ruth; Gilissen, Christian; Woestenenk, Rob; de Witte, Theo; Huls, Gerwin; van der Reijden, Bert A.; Jansen, Joop H.

    2016-01-01

    Although the vast majority of patients with a myelodysplastic syndrome (MDS) suffer from cytopenias, the bone marrow is usually normocellular or hypercellular. Apoptosis of hematopoietic cells in the bone marrow has been implicated in this phenomenon. However, in MDS it remains only partially

  3. IL8-CXCR2 pathway inhibition as a therapeutic strategy against MDS and AML stem cells.

    Science.gov (United States)

    Schinke, Carolina; Giricz, Orsolya; Li, Weijuan; Shastri, Aditi; Gordon, Shanisha; Barreyro, Laura; Barreryo, Laura; Bhagat, Tushar; Bhattacharyya, Sanchari; Ramachandra, Nandini; Bartenstein, Matthias; Pellagatti, Andrea; Boultwood, Jacqueline; Wickrema, Amittha; Yu, Yiting; Will, Britta; Wei, Sheng; Steidl, Ulrich; Verma, Amit

    2015-05-14

    Acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) are associated with disease-initiating stem cells that are not eliminated by conventional therapies. Novel therapeutic targets against preleukemic stem cells need to be identified for potentially curative strategies. We conducted parallel transcriptional analysis of highly fractionated stem and progenitor populations in MDS, AML, and control samples and found interleukin 8 (IL8) to be consistently overexpressed in patient samples. The receptor for IL8, CXCR2, was also significantly increased in MDS CD34(+) cells from a large clinical cohort and was predictive of increased transfusion dependence. High CXCR2 expression was also an adverse prognostic factor in The Cancer Genome Atlas AML cohort, further pointing to the critical role of the IL8-CXCR2 axis in AML/MDS. Functionally, CXCR2 inhibition by knockdown and pharmacologic approaches led to a significant reduction in proliferation in several leukemic cell lines and primary MDS/AML samples via induction of G0/G1 cell cycle arrest. Importantly, inhibition of CXCR2 selectively inhibited immature hematopoietic stem cells from MDS/AML samples without an effect on healthy controls. CXCR2 knockdown also impaired leukemic growth in vivo. Together, these studies demonstrate that the IL8 receptor CXCR2 is an adverse prognostic factor in MDS/AML and is a potential therapeutic target against immature leukemic stem cell-enriched cell fractions in MDS and AML. © 2015 by The American Society of Hematology.

  4. New q-ary quantum MDS codes with distances bigger than q/2

    Science.gov (United States)

    He, Xianmang; Xu, Liqing; Chen, Hao

    2016-07-01

    The construction of quantum MDS codes has been studied by many authors. We refer to the table in page 1482 of (IEEE Trans Inf Theory 61(3):1474-1484, 2015) for known constructions. However, there have been constructed only a few q-ary quantum MDS [[n,n-2d+2,d

  5. Therapy with low-dose azacitidine for MDS in children and young adults: a retrospective analysis of the EWOG-MDS study group.

    Science.gov (United States)

    Cseh, Annamaria M; Niemeyer, Charlotte M; Yoshimi, Ayami; Catala, Albert; Frühwald, Michael C; Hasle, Henrik; van den Heuvel-Eibrink, Mary M; Lauten, Melchior; De Moerloose, Barbara; Smith, Owen P; Bernig, Toralf; Gruhn, Bernd; Kulozik, Andreas E; Metzler, Markus; Olcay, Lale; Suttorp, Meinolf; Furlan, Ingrid; Strahm, Brigitte; Flotho, Christian

    2016-03-01

    Low-dose azacitidine is efficient and safe in the therapy of malignant myeloid disorders in adults but data in children are lacking. We present a retrospective analysis of 24 children and young adults with myelodysplastic syndrome (MDS) who received azacitidine at the time of first diagnosis or relapse after allotransplant (2 children were treated with azacitidine both initially and for relapse). Diagnoses were refractory cytopenia of childhood (N = 4), advanced primary MDS (N = 9) and secondary MDS (N = 11). The median duration of treatment was four cycles. Azacitidine was well tolerated, but cytopenias led to dose reduction in five cases. Treatment was discontinued in one child because of impaired renal function. Sixteen MDS patients were treated with azacitidine at first diagnosis. One complete clinical remission was observed and one child showed complete marrow remission; six children experienced stable disease with haematological improvement. Ten children received azacitidine for relapsed MDS after transplant: of these, seven experienced stable disease for 2-30 cycles (median 3), including one patient with haematological improvement for seven cycles. In summary, azacitidine is effective in some children with MDS and appears to be a non-toxic option in palliative situations to prolong survival. © 2016 John Wiley & Sons Ltd.

  6. [VALIDATION OF THE HUNGARIAN MDS-UPDRS: WHY DO WE NEED A NEW PARKINSON SCALE?].

    Science.gov (United States)

    Horvath, Krisztina; Aschermann Zsuzsanna; Acs, Péter; Bosnyák, Edit; Deli, Gabriella; Pál, Endre; Késmárki, Ildikó; Horváth Réka; Takács, Katalin; Komoly, Sámuel; Bokor, Magdolna; Rigó, Eszter; Lajtos, Júlia; Klivényi, Péter; Dibó, György; Vécsei, László; Takáts, Annamária; Tóth, Adrián; Imre, Piroska; Nagy, Ferenc; Herceg, Mihály; Hidasi, Eszter; Kovács, Norbert

    2014-03-30

    The Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has been published in 2008 as the successor of the original UPDRS. The MDS-UPDRS organizing team developed guidelines for the development of official non-English translations consisting of four steps: translation/back-translation, cognitive pretesting, large field testing, and clinimetric analysis. The aim of this paper was to introduce the new MDS-UPDRS and its validation process into Hungarian. Two independent groups of neurologists translated the text of the MDS-UPDRS into Hungarian and subsequently back-translated into English. After the review of the back-translated English version by the MDS-UPDRS translation administration team, cognitive pretesting was conducted with ten patients. Based on the results of the initial cognitive pretesting, another round was conducted. For the large field testing phase, the Hungarian official working draft version of MDS-UPDRS was tested with 357 patients with Parkinson's disease (PD). Confirmatory factor analyses (CFA) determined whether the factor structure for the English-language MDS-UPDRS could be confirmed in data collected using the Hungarian Official Draft Version. To become an official translation, the Comparative Fit Index (CFI) had to be ≥ 0.90 compared to the English-language version. For all four parts of the Hungarian MDS-UPDRS, the CFI was ≥ 0.94. The overall factor structure of the Hungarian version was consistent with that of the English version based on the high CFIs for all the four parts of the MDS-UPDRS in the CFA; therefore, this version was designated as the "OFFICIAL GUNGARIAN VERSION OF THE MDS-UPDRS'.

  7. [Application of Next Generation Sequencing for AML/MDS Diagnosis and Treatment].

    Science.gov (United States)

    Cheng, Huan-Chen; Liu, Sheng-Wei; Liu, Yu; Zhao, Xue-Fei; Li, Wei; Qiu, Lin; Ma, Jun

    2017-12-01

    To detect the mutations of AML/MDS- related genes by using next generation sequencing (NGS), to analyze the mutation levels of each genes in the AML/MDS and the sensitivity of NGS, and to evaluate the feasibility of gene mutations for monitoring the MRD and predicating the progression of diseases. The specimens were collected from primary AML (68 cases) and MDS (57 cases) patients from August 2015 to June 2016 in the Harbin Institute of Hematology and Oncology. The mutations of 22 related genes were detected by using AML/MDS-NGS chips. TET2 gene showed the highest mutation rate in AML (55.9%) and MDS (56.1%). The gene mutations were as follows: CEBPA (11.8%), DNMT3A (7.4%), C-KIT (7.4%) and FLT3-ITD (7.4%) in AML, and U2AF1 (10.5%) and SRSF2 (10.5%) in MDS. All the genes had specific mutation sites except TP53 and CEBPA. The mutations of FLT3, C-KIT and CEBPA became negative in the 5 AML patients in remission when compared with those at primary attack, but the mutation rate of TET2 gene was not obviously changed, whereas the mutation rate of the 5 MDS patients was not significantly changed. The new gene mutations appeared in 3 MDS patients with disease progression, but the mutation rate was not changed significantly in the disease progression. The gene mutation rate still has not been changed significantly even after remission. Both AML and MDS have their own specific mutated genes and sites. Some gene mutations, such as CEBPA, can be used as an effective indicator to monitoring MRD in AML patients, but those only used for the evaluation of the disease progression and prognosis in MDS patients.

  8. [Combination of busulfan with increased-dose of fludarabine as conditioning regimen for MDS and MDS-AML patients with allo-HSCT].

    Science.gov (United States)

    Yuan, Jing; Ren, Hanyun; Qiu, Zhixiang; Li, Yuan; Wang, Mangju; Liu, Wei; Xu, Weilin; Sun, Yuhua; Wang, Lihong; Liang, Zeyin; Dong, Yujun; Ou, Jinping; Wang, Wensheng; Yin, Yue; Cen, Xinan; Wang, Qian

    2015-06-01

    To investigate the safety and efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for myelodysplastic syndrome (MDS) and secondary acute myelogenous leukemia (MDS-AML) using conditioning regimen with busulfan (Bu) and increased-dose of fludarabine (ID-Flu). A total of 49 patients with MDS or MDS-AML were treated by allo-HSCT, the clinical data was analyzed retrospectively. All patients achieved hematopoietic reconstitution. Neutrophil engraftment was at 10 - 22 days (median 13 days), and platelet engraftment was at 8 - 66 days (median 16 days). The cumulative incidences of Ⅱ-Ⅳ degree acute graft-versus-host disease (GVHD), hemorrhagic cystitis (HC), and hepatic venous occlusive disease (VOD) were 28.6%, 14.3% and 2.0%, respectively. The transplant-related mortality (TRM) was only 4.1% at 100d and 8.2% at 1-92 months of followed-up (median 14 months) period. Overall survival (OS) and disease free survival (DFS) was 75.5%, 73.5%, respectively. Kaplan-Meier curve showed that 3-year OS and 3-year DFS was (71.1 ± 7.8)%, (66.7 ± 8.3)%, respectively, with a relapse incidence (RI) 16.3%. OS for MDS and MDS-AML was 81.5% and 68.2%, and RI in two settings was 3.7%, 31.8%, respectively. OS for MDS-AML at complete remission (CR) and non-CR subgroup was 83.3% and 50.0%, respectively, while cumulative RR was 16.7% and 50.0%, respectively. OS and RI except for non-CR subgroup were 82.1% and 7.7%. Univariate analysis showed that pre-HSCT disease status had correlation with OS (P=0.031), but age, decitabine in conditioning regimen, stem cell source, HLA matching, patient-donor gender, dose of mononuclear cells and GVHD had no correlation with OS. Bu/ID-Flu conditioning regimen for MDS and MDS-AML has high efficiency, fewer complications, lower toxicity and TRM. The OS and DFS were higher and RI was lower except for refractory MDS-AML patients. The regimen is valuable for clinical application.

  9. Epigenetically Aberrant Stroma in MDS Propagates Disease via Wnt/β-Catenin Activation.

    Science.gov (United States)

    Bhagat, Tushar D; Chen, Si; Bartenstein, Matthias; Barlowe, A Trevor; Von Ahrens, Dagny; Choudhary, Gaurav S; Tivnan, Patrick; Amin, Elianna; Marcondes, A Mario; Sanders, Mathijs A; Hoogenboezem, Remco M; Kambhampati, Suman; Ramachandra, Nandini; Mantzaris, Iaonnis; Sukrithan, Vineeth; Laurence, Remi; Lopez, Robert; Bhagat, Prafullla; Giricz, Orsi; Sohal, Davendra; Wickrema, Amittha; Yeung, Cecilia; Gritsman, Kira; Aplan, Peter; Hochedlinger, Konrad; Yu, Yiting; Pradhan, Kith; Zhang, Jinghang; Greally, John M; Mukherjee, Siddhartha; Pellagatti, Andrea; Boultwood, Jacqueline; Will, Britta; Steidl, Ulrich; Raaijmakers, Marc H G P; Deeg, H Joachim; Kharas, Michael G; Verma, Amit

    2017-09-15

    The bone marrow microenvironment influences malignant hematopoiesis, but how it promotes leukemogenesis has not been elucidated. In addition, the role of the bone marrow stroma in regulating clinical responses to DNA methyltransferase inhibitors (DNMTi) is also poorly understood. In this study, we conducted a DNA methylome analysis of bone marrow-derived stromal cells from myelodysplastic syndrome (MDS) patients and observed widespread aberrant cytosine hypermethylation occurring preferentially outside CpG islands. Stroma derived from 5-azacytidine-treated patients lacked aberrant methylation and DNMTi treatment of primary MDS stroma enhanced its ability to support erythroid differentiation. An integrative expression analysis revealed that the WNT pathway antagonist FRZB was aberrantly hypermethylated and underexpressed in MDS stroma. This result was confirmed in an independent set of sorted, primary MDS-derived mesenchymal cells. We documented a WNT/β-catenin activation signature in CD34 + cells from advanced cases of MDS, where it associated with adverse prognosis. Constitutive activation of β-catenin in hematopoietic cells yielded lethal myeloid disease in a NUP98-HOXD13 mouse model of MDS, confirming its role in disease progression. Our results define novel epigenetic changes in the bone marrow microenvironment, which lead to β-catenin activation and disease progression of MDS. Cancer Res; 77(18); 4846-57. ©2017 AACR . ©2017 American Association for Cancer Research.

  10. Agreement between hospital discharge diagnosis codes and medical records to identify metastatic colorectal cancer and associated comorbidities in elderly patients.

    Science.gov (United States)

    Gouverneur, A; Dolatkhani, D; Rouyer, M; Grelaud, A; Francis, F; Gilleron, V; Fourrier-Réglat, A; Noize, P

    2017-08-01

    Quality of coding to identify cancers and comorbidities through the French hospital diagnosis database (Programme de médicalisation des systèmes d'information, PMSI) has been little investigated. Agreement between medical records and PMSI database was evaluated regarding metastatic colorectal cancer (mCRC) and comorbidities. From 01/01/2013 to 06/30/2014, 74 patients aged≥65years at mCRC diagnosis were identified in Bordeaux teaching hospital. Data on mCRC and comorbidities were collected from medical records. All diagnosis codes (main, related and associated) registered into the PMSI were extracted. Agreement between sources was evaluated using the percent agreement for mCRC and the kappa (κ) statistic for comorbidities. Agreement for primary CRC and mCRC was higher using all types of diagnosis codes instead of the main one exclusively (respectively 95% vs. 53% for primary CRC and 91% vs. 24% for mCRC). Agreement was substantial (κ 0.65) for cardiovascular diseases, notably atrial fibrillation (κ 0.77) and hypertension (κ 0.68). It was moderate for psychiatric disorders (κ 0.49) and respiratory diseases (κ 0.48), although chronic obstructive pulmonary disease had a good agreement (κ 0.75). Within the class of endocrine, nutritional and metabolic diseases (κ 0.55), agreement was substantial for diabetes (κ 0.91), obesity (κ 0.82) and hypothyroidism (κ 0.72) and moderate for hypercholesterolemia (κ 0.51) and malnutrition (κ 0.42). These results are reassuring with regard to detection through PMSI of mCRC if all types of diagnosis codes are considered and useful to better choose comorbidities in elderly mCRC patients that could be well identified through hospital diagnosis codes. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. Increased separase activity and occurrence of centrosome aberrations concur with transformation of MDS.

    Science.gov (United States)

    Ruppenthal, Sabrina; Kleiner, Helga; Nolte, Florian; Fabarius, Alice; Hofmann, Wolf-Karsten; Nowak, Daniel; Seifarth, Wolfgang

    2018-01-01

    ESPL1/separase, a cysteine endopeptidase, is a key player in centrosome duplication and mitotic sister chromatid separation. Aberrant expression and/or altered separase proteolytic activity are associated with centrosome amplification, aneuploidy, tumorigenesis and disease progression. Since centrosome alterations are a common and early detectable feature in patients with myelodysplastic syndrome (MDS) and cytogenetic aberrations play an important role in disease risk stratification, we examined separase activity on single cell level in 67 bone marrow samples obtained from patients with MDS, secondary acute myeloid leukemia (sAML), de novo acute myeloid leukemia (AML) and healthy controls by a flow cytometric separase activity assay. The separase activity distribution (SAD) value, a calculated measure for the occurrence of cells with prominent separase activity within the analyzed sample, was tested for correlation with the centrosome, karyotype and gene mutation status. We found higher SAD values in bone marrow cells of sAML patients than in corresponding cells of MDS patients. This concurred with an increased incidence of aberrant centrosome phenotypes in sAML vs. MDS samples. No correlation was found between SAD values and the karyotype/gene mutation status. During follow-up of four MDS patients we observed increasing SAD values after transformation to sAML, in two patients SAD values decreased during azacitidine therapy. Cell culture experiments employing MDS-L cells as an in vitro model of MDS revealed that treatment with rigosertib, a PLK1 inhibitor and therapeutic drug known to induce G2/M arrest, results in decreased SAD values. In conclusion, the appearance of cells with unusual high separase activity levels, as indicated by increased SAD values, concurs with the transformation of MDS to sAML and may reflect separase dysregulation potentially contributing to clonal evolution during MDS progression. Separase activity measurement may therefore be useful as a

  12. Risk-adjustment models for heart failure patients' 30-day mortality and readmission rates: the incremental value of clinical data abstracted from medical charts beyond hospital discharge record.

    Science.gov (United States)

    Lenzi, Jacopo; Avaldi, Vera Maria; Hernandez-Boussard, Tina; Descovich, Carlo; Castaldini, Ilaria; Urbinati, Stefano; Di Pasquale, Giuseppe; Rucci, Paola; Fantini, Maria Pia

    2016-09-06

    Hospital discharge records (HDRs) are routinely used to assess outcomes of care and to compare hospital performance for heart failure. The advantages of using clinical data from medical charts to improve risk-adjustment models remain controversial. The aim of the present study was to evaluate the additional contribution of clinical variables to HDR-based 30-day mortality and readmission models in patients with heart failure. This retrospective observational study included all patients residing in the Local Healthcare Authority of Bologna (about 1 million inhabitants) who were discharged in 2012 from one of three hospitals in the area with a diagnosis of heart failure. For each study outcome, we compared the discrimination of the two risk-adjustment models (i.e., HDR-only model and HDR-clinical model) through the area under the ROC curve (AUC). A total of 1145 and 1025 patients were included in the mortality and readmission analyses, respectively. Adding clinical data significantly improved the discrimination of the mortality model (AUC = 0.84 vs. 0.73, p < 0.001), but not the discrimination of the readmission model (AUC = 0.65 vs. 0.63, p = 0.08). We identified clinical variables that significantly improved the discrimination of the HDR-only model for 30-day mortality following heart failure. By contrast, clinical variables made little contribution to the discrimination of the HDR-only model for 30-day readmission.

  13. Cytomorphology review of 100 newly diagnosed lower-risk MDS patients in the European LeukemiaNet MDS (EUMDS) registry reveals a high inter-observer concordance.

    Science.gov (United States)

    de Swart, Louise; Smith, Alex; MacKenzie, Marius; Symeonidis, Argiris; Neukirchen, Judith; Mikulenková, Dana; Vallespí, Teresa; Zini, Gina; Paszkowska-Kowalewska, Malgorzata; Kruger, Anton; Saft, Leonie; Fenaux, Pierre; Bowen, David; Hellström-Lindberg, Eva; Čermák, Jaroslav; Stauder, Reinhard; Tatic, Aurelia; Holm, Mette Skov; Malcovati, Luca; Mądry, Krzysztof; Droste, Jackie; Blijlevens, Nicole; de Witte, Theo; Germing, Ulrich

    2017-07-01

    The European LeukemiaNet MDS (EUMDS) registry is collecting data of myelodysplastic syndrome (MDS) patients belonging to the IPSS low or intermediate-1 category, newly diagnosed by local cytologists. The diagnosis of MDS can be challenging, and some data report inter-observer variability with regard to the assessment of the MDS subtype. In order to ensure that correct diagnoses were made by the participating centres, blood and bone marrow slides of 10% of the first 1000 patients were reviewed by an 11-person panel of cytomorphologists. All slides were rated by at least 3 panel members (median 8 panel members; range 3-9). Marrow slides from 98 out of 105 patients were of good quality and therefore could be rated properly according to the WHO 2001 classification, including assessment of dysplastic lineages. The agreement between the reviewers whether the diagnosis was MDS or non-MDS was strong with an intra-class correlation coefficient (ICC) of 0.85. Six cases were detected not to fit the entry criteria of the registry, because they were diagnosed uniformly as CMML or AML by the panel members. The agreement by WHO 2001 classification was strong as well (ICC = 0.83). The concordance of the assessment of dysplastic lineages was substantial for megakaryopoiesis and myelopoiesis and moderate for erythropoiesis. Our data show that in general, the inter-observer agreement was high and a very low percentage of misdiagnosed cases had been entered into the EUMDS registry. Further studies including histomorphology are warranted.

  14. Mammalian-target of rapamycin inhibition with temsirolimus in myelodysplastic syndromes (MDS) patients is associated with considerable toxicity: results of the temsirolimus pilot trial by the German MDS Study Group (D-MDS).

    Science.gov (United States)

    Wermke, Martin; Schuster, Claudia; Nolte, Florian; Al-Ali, Haifa-Kathrin; Kiewe, Philipp; Schönefeldt, Claudia; Jakob, Christiane; von Bonin, Malte; Hentschel, Leopold; Klut, Ina-Maria; Ehninger, Gerhard; Bornhäuser, Martin; Baretton, Gustavo; Germing, Ulrich; Herbst, Regina; Haase, Detelef; Hofmann, Wolf K; Platzbecker, Uwe

    2016-12-01

    The mammalian-target of rapamycin (also termed mechanistic target of rapamycin, mTOR) pathway integrates various pro-proliferative and anti-apoptotic stimuli and is involved in regulatory T-cell (TREG) development. As these processes contribute to the pathogenesis of myelodysplastic syndromes (MDS), we hypothesized that mTOR modulation with temsirolimus (TEM) might show activity in MDS. This prospective multicentre trial enrolled lower and higher risk MDS patients, provided that they were transfusion-dependent/neutropenic or relapsed/refractory to 5-azacitidine, respectively. All patients received TEM at a weekly dose of 25 mg. Of the 9 lower- and 11 higher-risk patients included, only 4 (20%) reached the response assessment after 4 months of treatment and showed stable disease without haematological improvement. The remaining patients discontinued TEM prematurely due to adverse events. Median overall survival (OS) was not reached in the lower-risk group and 296 days in the higher-risk group. We observed a significant decline of bone marrow (BM) vascularisation (P = 0·006) but were unable to demonstrate a significant impact of TEM on the balance between TREG and pro-inflammatory T-helper-cell subsets within the peripheral blood or BM. We conclude that mTOR-modulation with TEM at a dose of 25 mg per week is accompanied by considerable toxicity and has no beneficial effects in elderly MDS patients. © 2016 John Wiley & Sons Ltd.

  15. MDS 3.0 for Nursing Homes and Swing Bed Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MDS is a powerful tool for implementing standardized assessment and for facilitating care management in nursing homes (NHs) and non-critical access hospital...

  16. Pancreatitis - discharge

    Science.gov (United States)

    Chronic pancreatitis - discharge; Pancreatitis - chronic - discharge; Pancreatic insufficiency - discharge; Acute pancreatitis - discharge ... You were in the hospital because you have pancreatitis. This is a swelling of the pancreas. You ...

  17. Minimum variance and variance of outgoing quality limit MDS-1(c1, c2) plans

    Science.gov (United States)

    Raju, C.; Vidya, R.

    2016-06-01

    In this article, the outgoing quality (OQ) and total inspection (TI) of multiple deferred state sampling plans MDS-1(c1,c2) are studied. It is assumed that the inspection is rejection rectification. Procedures for designing MDS-1(c1,c2) sampling plans with minimum variance of OQ and TI are developed. A procedure for obtaining a plan for a designated upper limit for the variance of the OQ (VOQL) is outlined.

  18. Independent Validation of the SEND-PD and Correlation with the MDS-UPDRS Part IA

    Directory of Open Access Journals (Sweden)

    Mayela Rodríguez-Violante

    2014-01-01

    Full Text Available Introduction. Neuropsychiatric symptoms in Parkinson’s disease can be assessed by the MDS-UPDRS part IA. The Scale for Evaluation of Neuropsychiatric Disorders in Parkinson’s disease (SEND-PD has been recently developed to assess the severity of some neuropsychiatric symptoms. The objective of this study is to compare the performance of the SEND-PD with the corresponding items of the MDS-UPDRS part IA. Methods. Patients with Parkinson’s disease were evaluated using the MDS-UPDRS and the SEND-PD by independent raters. Partial SEND-PD and neuropsychiatric MDS-UPDRS part IA were constructed with equivalent items for comparison. Results. A total of 260 consecutive patients were included. Overall, 61.2% of the patients did not report any psychotic symptom and 83.5% did not report any ICD symptom. On the other hand, 78.5% of the patients did report at least one symptom related to apathy, depression, or anxiety. The partial SEND-PD score was 2.9±3.1 (range from 0 to 16. The neuropsychiatric MDS-UPDRS part IA score was 2.9±3 (range from 0 to 14. The correlation coefficient between corresponding items ranged from 0.67 to 0.98 and between both summary indexes was rs=0.93 (all, P<0.001. Conclusion. A high association between equivalent items of the SEND-PD and the MDS-UPDRS was found.

  19. Therapy-related AML/MDS after treatment of low-grade B-cell lymphoma

    International Nuclear Information System (INIS)

    Yanada, Masamitsu

    2008-01-01

    Described is the therapy-related AML (acute myelogenetic leukemia)/MDS (myelo-dysplasia syndrome), which is manifested after various treatments of low-grade B-cell lymphoma and has strongly attracted attention because of the markedly improved prognosis due to recent advantages of the therapy for the disease. AML/MDS occurs several years after chemotherapy and/or radiation therapy which cause DNA damage in hematopoietic cells, and the AML/MDS risk is known increased in patients undergone especially with autologous transplantation of those cells. AML/MDS has the feature similar to that caused either by alkylating agent or by topoisomerase-2 inhibitor, and the disease by radiation belong to the former. Yet unclear is the problem whether malignant cells causing the disease after therapy are derived from the remaining cells in the graft or in the body. Although irradiations of total body and total lymphaden as well as chemotherapy are said to be related to AML/MDS and local irradiation does not contribute to its risk, the most important factor for the disease is considered to be the autotransplantation as the recurrence occurs in 50% after it. Thus the treatment history should be taken into consideration for suppressing AML/MDS, for which follow up with consideration for the disease is required particularly after autotransplantation. (R.T.)

  20. Age-related inflammatory bone marrow microenvironment induces ineffective erythropoiesis mimicking del(5q) MDS.

    Science.gov (United States)

    Mei, Y; Zhao, B; Basiorka, A A; Yang, J; Cao, L; Zhang, J; List, A; Ji, P

    2018-04-01

    Anemia is characteristic of myelodysplastic syndromes (MDS). The mechanisms of anemia in MDS are unclear. Using a mouse genetic approach, here we show that dual deficiency of mDia1 and miR-146a, encoded on chromosome 5q and commonly deleted in MDS (del(5q) MDS), causes an age-related anemia and ineffective erythropoiesis mimicking human MDS. We demonstrate that the ageing bone marrow microenvironment is important for the development of ineffective erythropoiesis in these mice. Damage-associated molecular pattern molecules (DAMPs), whose levels increase in ageing bone marrow, induced TNFα and IL-6 upregulation in myeloid-derived suppressor cells (MDSCs) in mDia1/miR-146a double knockout mice. Mechanistically, we reveal that pathologic levels of TNFα and IL-6 inhibit erythroid colony formation and differentially affect terminal erythropoiesis through reactive oxygen species-induced caspase-3 activation and apoptosis. Treatment of the mDia1/miR-146a double knockout mice with all-trans retinoic acid, which promoted the differentiation of MDSCs and ameliorated the inflammatory bone marrow microenvironment, significantly rescued anemia and ineffective erythropoiesis. Our study underscores the dual roles of the ageing microenvironment and genetic abnormalities in the pathogenesis of ineffective erythropoiesis in del(5q) MDS.

  1. Statistical forecast of seasonal discharge in Central Asia using observational records: development of a generic linear modelling tool for operational water resource management

    Directory of Open Access Journals (Sweden)

    H. Apel

    2018-04-01

    Full Text Available The semi-arid regions of Central Asia crucially depend on the water resources supplied by the mountainous areas of the Tien Shan and Pamir and Altai mountains. During the summer months the snow-melt- and glacier-melt-dominated river discharge originating in the mountains provides the main water resource available for agricultural production, but also for storage in reservoirs for energy generation during the winter months. Thus a reliable seasonal forecast of the water resources is crucial for sustainable management and planning of water resources. In fact, seasonal forecasts are mandatory tasks of all national hydro-meteorological services in the region. In order to support the operational seasonal forecast procedures of hydro-meteorological services, this study aims to develop a generic tool for deriving statistical forecast models of seasonal river discharge based solely on observational records. The generic model structure is kept as simple as possible in order to be driven by meteorological and hydrological data readily available at the hydro-meteorological services, and to be applicable for all catchments in the region. As snow melt dominates summer runoff, the main meteorological predictors for the forecast models are monthly values of winter precipitation and temperature, satellite-based snow cover data, and antecedent discharge. This basic predictor set was further extended by multi-monthly means of the individual predictors, as well as composites of the predictors. Forecast models are derived based on these predictors as linear combinations of up to four predictors. A user-selectable number of the best models is extracted automatically by the developed model fitting algorithm, which includes a test for robustness by a leave-one-out cross-validation. Based on the cross-validation the predictive uncertainty was quantified for every prediction model. Forecasts of the mean seasonal discharge of the period April to September are derived

  2. Statistical forecast of seasonal discharge in Central Asia using observational records: development of a generic linear modelling tool for operational water resource management

    Science.gov (United States)

    Apel, Heiko; Abdykerimova, Zharkinay; Agalhanova, Marina; Baimaganbetov, Azamat; Gavrilenko, Nadejda; Gerlitz, Lars; Kalashnikova, Olga; Unger-Shayesteh, Katy; Vorogushyn, Sergiy; Gafurov, Abror

    2018-04-01

    The semi-arid regions of Central Asia crucially depend on the water resources supplied by the mountainous areas of the Tien Shan and Pamir and Altai mountains. During the summer months the snow-melt- and glacier-melt-dominated river discharge originating in the mountains provides the main water resource available for agricultural production, but also for storage in reservoirs for energy generation during the winter months. Thus a reliable seasonal forecast of the water resources is crucial for sustainable management and planning of water resources. In fact, seasonal forecasts are mandatory tasks of all national hydro-meteorological services in the region. In order to support the operational seasonal forecast procedures of hydro-meteorological services, this study aims to develop a generic tool for deriving statistical forecast models of seasonal river discharge based solely on observational records. The generic model structure is kept as simple as possible in order to be driven by meteorological and hydrological data readily available at the hydro-meteorological services, and to be applicable for all catchments in the region. As snow melt dominates summer runoff, the main meteorological predictors for the forecast models are monthly values of winter precipitation and temperature, satellite-based snow cover data, and antecedent discharge. This basic predictor set was further extended by multi-monthly means of the individual predictors, as well as composites of the predictors. Forecast models are derived based on these predictors as linear combinations of up to four predictors. A user-selectable number of the best models is extracted automatically by the developed model fitting algorithm, which includes a test for robustness by a leave-one-out cross-validation. Based on the cross-validation the predictive uncertainty was quantified for every prediction model. Forecasts of the mean seasonal discharge of the period April to September are derived every month from

  3. Heart pacemaker - discharge

    Science.gov (United States)

    Cardiac pacemaker implantation - discharge; Artificial pacemaker - discharge; Permanent pacemaker - discharge; Internal pacemaker - discharge; Cardiac resynchronization therapy - discharge; CRT - discharge; ...

  4. A phase 1/2 study of rigosertib in patients with myelodysplastic syndromes (MDS) and MDS progressed to acute myeloid leukemia.

    Science.gov (United States)

    Navada, Shyamala C; Fruchtman, Steven M; Odchimar-Reissig, Rosalie; Demakos, Erin P; Petrone, Michael E; Zbyszewski, Patrick S; Holland, James F; Silverman, Lewis R

    2018-01-01

    This Phase 1/2, dose-escalating study of rigosertib enrolled 22 patients with higher-risk myelodysplastic syndromes (MDS) (n=9) and acute myeloid leukemia (AML; n=13) who had relapsed or were refractory to standard therapy and for whom no second-line therapies were approved. Patients received 3- to 7-day continuous intravenous infusions of rigosertib, an inhibitor of Ras-effector pathways that interacts with the Ras-binding domains, common to several signaling proteins including Raf and PI3 kinase. Rigosertib was administered at doses of 650-1700mg/m 2 /day in 14-day cycles. Initial dose escalation followed a Fibonacci scheme, followed by recommended phase 2 dose confirmation in an expanded cohort. Rigosertib was well tolerated for up to 23 cycles, with no treatment-related deaths and 18% of patients with related serious adverse events (AEs). Common AEs were fatigue, diarrhea, pyrexia, dyspnea, insomnia, and anemia. Rigosertib exhibited biologic activity, with reduction or stabilization of bone marrow blasts and improved peripheral blood counts in a subset of patients. Ten of 19 evaluable patients (53%) demonstrated bone marrow/peripheral blood responses (n=4 MDS, n=1 AML) or stable disease (n=3 MDS, n=2 AML). Median survival was 15.7 and 2.0 months for responders and non-responders, respectively. Additional studies of rigosertib are ongoing in higher-risk MDS (NCT00854646). Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Flow cytometry in the diagnosis of myelodysplastic syndromes (MDS) and the value of myeloid nuclear differentiation antigen (MNDA).

    Science.gov (United States)

    Bellos, Frauke; Kern, Wolfgang

    2014-09-25

    Background: Confirming diagnosis of myelodysplastic syndromes (MDS) is often challenging. Standard diagnostic methods are cytomorphology (CM) and cytogenetics (CG). Multiparameter flow cytometry (MFC) is upcoming in MDS diagnostic work up, comparability and investigator experience are critical. Myeloid nuclear differentiation antigen (MNDA) in myelomonocytic cells might be expressed more weakly in patients with MDS. The analysis of MNDA may thus improve diagnostic capabilities of MFC in MDS. Methods: Staining methods and antibody combinations for MFC in MDS are outlined, giving details for interpretation of results in regard to dyspoiesis. MFC results are correlated with CM and CG and with survival data. Use of myeloid nuclear differentiation antigen (MNDA) in MDS diagnostics was evaluated in 239 patients with MDS, AML, other cytopenic conditions and in 30 negative controls. Results: Strong correlation between findings in CM and MFC was found; MFC results correlated well with those of CG. Patients with higher grades of dysplasia in MFC had shorter overall survival. Percentages of granulocytes and monocytes with diminished MNDA expression (%dimG, %dimM) were higher in patients with MDS and AML. Mean fluorescence intensity (MFI) of MNDA in monocytes was lower in MDS and AML. Cut-off values for %dimG (12%) and %dimM (22%) as well as for MFI in monocytes (72) were defined discriminating between MDS and non-MDS. Conclusion: MFC adds significant information on dyspoiesis in the diagnostic work up for MDS and provides prognostic information. MNDA expression can be assessed by MFC and may facilitate evaluation of dyspoiesis when added to MDS MFC panels. © 2014 Clinical Cytometry Society. Copyright © 2014 Clinical Cytometry Society.

  6. [Inhibitory Effect of Decitabine on Proliferation of MDS-L Cells and Its Mechanism].

    Science.gov (United States)

    Wu, Dong; Zhang, Yao; Zhao, You-Shan; Guo, Juan; Chang, Chun-Kang

    2017-10-01

    To investigate the inhibitory effect of decitabine (DAC) in various dosages on the proliferention of MDS-RAEB cell line MDS-L and its mechanism. LC-MS/MS method was used to test the blood DAC concentration of 2 groups of MDS patients being treated with DAC 20 and 15 mg/m 2 ×5 d. In according to the various blood DAC concentration levels, the MDS-L cells were treated with different DAC dosages for 24, 48, 72 and 96 h, respectively. The CCK-8 method was applied to determine the cell proliferation, the flow cytometry was used to analyze the cell cycle and cell apoptosis changes, the P15 INK4B DNA methylation status was measured by methylation specific PCR using EZ DNA Methylation-Gold Kit. The blood DAC concentration of MDS patients treated with DAC 20 mg/m 2 ×5 d was 174.08±80.15(84.7-311) ng/ml, which was significantly higher than 89.87±32.94(43.2-165)ng/ml for the group treated with 15 mg/m 2 ×5 d (P=0.014). DAC could notably inhibit the proliferation of MDS-L cells, and the effect was in dose- and- time-dependent manner(r=0.786). However, when DAC concentration was ≥0.1 µg/ml, the proliferation inhibition rates were not significantly different between various dosages. After DAC treatment, MDS-L cells in G 1 phase increased notably, while cells in S phase decreased significantly. Also, the P15 INK4B DNA methylation status of MDS-L cells decreased after being treated with DAC for 96 h, but the difference was not significant between various dosages. DAC can significantly suppress MDS-L cell proliferation, block MDS-L cells in G 1 phase and induce the apoptosis at low concentration (0.1-0.2 µg/ml).

  7. [Establishment of Primary Adult MDS Nested Case-Control Study Cohort and Study of Risk Factors Associated with MDS Evolution to Leukemia].

    Science.gov (United States)

    Ma, Yan; Chen, Bo-Bin; Wang, Xiao-Qin; Xu, Xiao-Ping; Lin, Guo-Wei

    2015-12-01

    To establish a nested case-control study cohort in myelodysplastic syndrome (MDS) patients and investigate the clinical characteristics, WHO subtype and risk factors associated with MDS evolution to leukemia of this cohort. All patients, ≥18 years of age, provided by 24 Shanghai hospitals with initial clinical findings consistent with a hematopoietic abnormality between June 2003 and April 2007, were the candidates for inclusion in this study. The blood and bone marrow samples of every patient should be provided at baseline. Diagnosis was made by incorporating morphologic, immunophenotypic, cytogenetic and molecular features according to WHO classification criteria. Cytogenetic analysis was performed using conventional G-banding karyotyping and fluorescence in situ hybridization (FISH) techniques. Cumulative risk of evolution was estimated by Kaplan-Meier method. Prognostic factors were evaluated by univariate Log-rank method and multivariate Cox proportional hazard models. A total of 435 patients were diagnosed as MDS. The median age of MDS onset was 58(18-90) years, with 248 male patients and 187 female patients (male: female 1.33: 1). The percentage of cases with refractory cytopenia with multilineage dysplasia (RCMD) was the highest (65.5%), while that of refraetory anemia (RA) (2.3%), refractory anenia with ring sideroblast (RARS) (1.1%) and 5q-syndrome (0.5%) was lower. Trisomy 8 (+8) was the most common chromosome abnormalities (71 cases, 12.7%). The mean follow-up time was 20.3 (4.2-57.1) months. Cases were patients with evolution by the end of follow-up, while controls were patients without evolution by that time. Case group included 41 patients and control group included 342 patients. Univariate analysis showed that the age, sex, WHO subtype, WBC count, absolute neutrophil count (ANC), IPSS cytogenetic subgroup, IPSS group and bone marrow blast percentage were significant risk factors for leukemia-free survival (LFS). Multivariate analysis of COX model

  8. The Scottish school leavers cohort: linkage of education data to routinely collected records for mortality, hospital discharge and offspring birth characteristics.

    Science.gov (United States)

    Stewart, Catherine H; Dundas, Ruth; Leyland, Alastair H

    2017-07-10

    The Scottish school leavers cohort provides population-wide prospective follow-up of local authority secondary school leavers in Scotland through linkage of comprehensive education data with hospital and mortality records. It considers educational attainment as a proxy for socioeconomic position in young adulthood and enables the study of associations and causal relationships between educational attainment and health outcomes in young adulthood. Education data for 284 621 individuals who left a local authority secondary school during 2006/2007-2010/2011 were linked with birth, death and hospital records, including general/acute and mental health inpatient and day case records. Individuals were followed up from date of school leaving until September 2012. Age range during follow-up was 15 years to 24 years. Education data included all formal school qualifications attained by date of school leaving; sociodemographic information; indicators of student needs, educational or non-educational support received and special school unit attendance; attendance, absence and exclusions over time and school leaver destination. Area-based measures of school and home deprivation were provided. Health data included dates of admission/discharge from hospital; principal/secondary diagnoses; maternal-related, birth-related and baby-related variables and, where relevant, date and cause of death. This paper presents crude rates for all-cause and cause-specific deaths and general/acute and psychiatric hospital admissions as well as birth outcomes for children of female cohort members. This study is the first in Scotland to link education and health data for the population of local authority secondary school leavers and provides access to a large, representative cohort with the ability to study rare health outcomes. There is the potential to study health outcomes over the life course through linkage with future hospital and death records for cohort members. The cohort may also be

  9. Randomized phase 2 study of low-dose decitabine vs low-dose azacitidine in lower-risk MDS and MDS/MPN.

    Science.gov (United States)

    Jabbour, Elias; Short, Nicholas J; Montalban-Bravo, Guillermo; Huang, Xuelin; Bueso-Ramos, Carlos; Qiao, Wei; Yang, Hui; Zhao, Chong; Kadia, Tapan; Borthakur, Gautam; Pemmaraju, Naveen; Sasaki, Koji; Estrov, Zeev; Cortes, Jorge; Ravandi, Farhad; Alvarado, Yesid; Komrokji, Rami; Sekeres, Mikkael A; Steensma, David P; DeZern, Amy; Roboz, Gail; Kantarjian, Hagop; Garcia-Manero, Guillermo

    2017-09-28

    Hypomethylating agents (HMAs) improve survival in patients with higher-risk myelodysplastic syndromes (MDS) but are less well-studied in lower-risk disease. We compared the safety and efficacy of low-dose decitabine vs low-dose azacitidine in this group of patients. Adults with low- or intermediate 1-risk MDS or MDS/myeloproliferative neoplasm (MPN), including chronic myelomonocytic leukemia, according to the International Prognostic Scoring System, were randomly assigned using a Bayesian adaptive design to receive either azacitidine 75 mg/m 2 intravenously/subcutaneously daily or decitabine 20 mg/m 2 intravenously daily for 3 consecutive days on a 28-day cycle. The primary outcome was overall response rate (ORR). Between November 2012 and February 2016, 113 patients were treated: 40 (35%) with azacitidine and 73 (65%) with decitabine. The median age was 70 years; 81% of patients were intermediate 1-risk patients. The median number of cycles received was 9. The ORRs were 70% and 49% ( P = .03) for patients treated with decitabine and azacitidine, respectively. Thirty-two percent of patients treated with decitabine became transfusion independent compared with 16% of patients treated with azacitidine ( P = .2). Cytogenetic response rates were 61% and 25% ( P = .02), respectively. With a median follow-up of 20 months, the overall median event-free survival was 18 months: 20 and 13 months for patients treated with decitabine and azacitidine, respectively ( P = .1). Treatment was well tolerated, with a 6-week mortality rate of 0%. The use of low-dose HMAs is safe and effective in patients with lower-risk MDS and MDS/MPN. Their effect on the natural history of lower-risk disease needs to be further studied. This trial was registered at clinicaltrials.gov (identifier NCT01720225). © 2017 by The American Society of Hematology.

  10. Studies on the tumor initiation/promotion potential of six middle distillates (MDs) in mouse skin.

    Science.gov (United States)

    Jungen, H; Mellert, W; Wenzel-Hartung, R

    1995-08-01

    Six middle distillates (MDs) were tested for tumor initiating/promoting activity after application to the skin of 30 male CD-1 (ICR) BR mice per group. As the control, 7,12-dimethylbenz[a]-anthracene (DMBA) was used for initiation followed by 12-O-tetradecanoylphorbol-13-acetate (TPA) for promotion. For assessing the tumor-initiating activity, 50 microliters of neat MDs was administered for 5 days with subsequent TPA promotion. In the promotion bioassay, after DMBA initiation 50 microliters of the neat MDs was administered twice weekly until Week 28. For the examination of complete carcinogenic activity, one MD was given without DMBA initiation. Hyperkeratosis, hyperplasia, and dermal inflammation, occurring during the initiation with the MDs, were completely reversible during the 2-week treatment-free period after initiation. Similar skin findings were observed during promotion with the MDs. Regarding the number of affected animals and the severity of the response, TPA was more irritating than the MDs. The initiation study revealed skin tumors for the DMBA/TPA control (30/30), MD 57,389 (14/30), MD 57,396 (5/30), MD 57,383 (4/30) and MD 57,324 (2/30). The promotion study revealed tumor induction by MDs 57,389 (9/30), 57,324 (1/30), 57,393 (1/30), and 57,396 (1/30). Two of 30 animals treated with MD 57,389 developed tumors without DMBA initiation thus indicating that it also is a complete carcinogen. MD 57,399 caused neither initiating nor promoting effects. The tumors observed were diagnosed histopathologically predominantly as squamous cell papillomas.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. MDS-associated somatic mutations and clonal hematopoiesis are common in idiopathic cytopenias of undetermined significance.

    Science.gov (United States)

    Kwok, Brian; Hall, Jeff M; Witte, John S; Xu, Yin; Reddy, Prashanti; Lin, Keming; Flamholz, Rachel; Dabbas, Bashar; Yung, Aine; Al-Hafidh, Jenan; Balmert, Emily; Vaupel, Christine; El Hader, Carlos; McGinniss, Matthew J; Nahas, Shareef A; Kines, Julie; Bejar, Rafael

    2015-11-19

    Establishing a diagnosis in patients suspected of having a myelodysplastic syndrome (MDS) can be challenging and could be informed by the identification of somatic mutations. We performed a prospective study to examine the frequency and types of mutations encountered in 144 patients with unexplained cytopenias. Based on bone marrow findings, 17% were diagnosed with MDS, 15% with idiopathic cytopenias of undetermined significance (ICUS) and some evidence of dysplasia, and 69% with ICUS and no dysplasia. Bone marrow DNA was sequenced for mutations in 22 frequently mutated myeloid malignancy genes. Somatic mutations were identified in 71% of MDS patients, 62% of patients with ICUS and some dysplasia, and 20% of ICUS patients and no dysplasia. In total, 35% of ICUS patients carried a somatic mutation or chromosomal abnormality indicative of clonal hematopoiesis. We validated these results in a cohort of 91 lower-risk MDS and 249 ICUS cases identified over a 6-month interval. Mutations were found in 79% of those with MDS, in 45% of those with ICUS with dysplasia, and in 17% of those with ICUS without dysplasia. The spectrum of mutated genes was similar with the exception of SF3B1 which was rarely mutated in patients without dysplasia. Variant allele fractions were comparable between clonal ICUS (CCUS) and MDS as were mean age and blood counts. We demonstrate that CCUS is a more frequent diagnosis than MDS in cytopenic patients. Clinical and mutational features are similar in these groups and may have diagnostic utility once outcomes in CCUS patients are better understood. © 2015 by The American Society of Hematology.

  12. SETBP1 mutations drive leukemic transformation in ASXL1-mutated MDS.

    Science.gov (United States)

    Inoue, D; Kitaura, J; Matsui, H; Hou, H-A; Chou, W-C; Nagamachi, A; Kawabata, K C; Togami, K; Nagase, R; Horikawa, S; Saika, M; Micol, J-B; Hayashi, Y; Harada, Y; Harada, H; Inaba, T; Tien, H-F; Abdel-Wahab, O; Kitamura, T

    2015-04-01

    Mutations in ASXL1 are frequent in patients with myelodysplastic syndrome (MDS) and are associated with adverse survival, yet the molecular pathogenesis of ASXL1 mutations (ASXL1-MT) is not fully understood. Recently, it has been found that deletion of Asxl1 or expression of C-terminal-truncating ASXL1-MTs inhibit myeloid differentiation and induce MDS-like disease in mice. Here, we find that SET-binding protein 1 (SETBP1) mutations (SETBP1-MT) are enriched among ASXL1-mutated MDS patients and associated with increased incidence of leukemic transformation, as well as shorter survival, suggesting that SETBP1-MT play a critical role in leukemic transformation of MDS. We identify that SETBP1-MT inhibit ubiquitination and subsequent degradation of SETBP1, resulting in increased expression. Expression of SETBP1-MT, in turn, inhibited protein phosphatase 2A activity, leading to Akt activation and enhanced expression of posterior Hoxa genes in ASXL1-mutant cells. Biologically, SETBP1-MT augmented ASXL1-MT-induced differentiation block, inhibited apoptosis and enhanced myeloid colony output. SETBP1-MT collaborated with ASXL1-MT in inducing acute myeloid leukemia in vivo. The combination of ASXL1-MT and SETBP1-MT activated a stem cell signature and repressed the tumor growth factor-β signaling pathway, in contrast to the ASXL1-MT-induced MDS model. These data reveal that SETBP1-MT are critical drivers of ASXL1-mutated MDS and identify several deregulated pathways as potential therapeutic targets in high-risk MDS.

  13. Telomere dynamics in patients with del (5q) MDS before and under treatment with lenalidomide.

    Science.gov (United States)

    Beier, Fabian; Masouleh, Behzad Kharabi; Buesche, Guntram; Ventura Ferreira, Monica S; Schneider, Rebekka K; Ziegler, Patrick; Wilop, Stefan; Vankann, Lucia; Gattermann, Norbert; Platzbecker, Uwe; Giagounidis, Aristoteles; Götze, Katharina S; Nolte, Florian; Hofmann, Wolf-Karsten; Haase, Detlef; Kreipe, Hans; Panse, Jens; Blasco, Maria A; Germing, Ulrich; Brümmendorf, Tim H

    2015-09-21

    Myelodysplastic syndrome (MDS) associated with an acquired, isolated deletion of chromosome 5q (del (5q) MDS), represent a clonal disorder of hematopoiesis and a clinically distinct entity of MDS. Treatment of del (5q) MDS with the drug lenalidomide has significantly improved quality of life leading to transfusion independence and complete cytogenetic response rates (CCR) in the majority of patients. Telomeres are located at the end of eukaryotic chromosomes and are linked to replicative history/potential as well as genetic (in) stability of hematopoietic stem cells. Here, we analyzed telomere length (TL) dynamics before and under lenalidomide treatment in the peripheral blood and/or bone marrow of del (5q) patients enrolled in the LEMON-5 study (NCT01081431). Hematopoietic cells from del (5q) MDS patients were characterized by significantly shortened TL compared to age-matched healthy controls. Telomere loss was more accelerated in patients with longer disease duration (>2 years) and more pronounced cytopenias. Sequential analysis under lenalidomide treatment revealed that previously shortened TL in peripheral blood cells was significantly "elongated" towards normal levels within the first six months suggesting a shift from clonal del (5q) cells towards normal hematopoiesis in lenalidomide treated MDS patients. Taken together our findings suggest that the development of the del (5q) clone is associated with accelerated telomere shortening at diagnosis. However, upon induction of CCR and reoccurrence of normal hematopoiesis, the lack of a persistent TL deficit argues against telomere-mediated genetic instability neither as a disease-promoting event of del (5q) MDS nor for lenalidomide mediated development of secondary primary malignancies of the hematopoietic system in responding patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Nipple Discharge

    Science.gov (United States)

    ... any unexpected nipple discharge evaluated by a doctor. Nipple discharge in men under any circumstances could be a problem and needs further evaluation. One or both breasts may produce a nipple discharge, either spontaneously or when you squeeze your ...

  15. MDS-UPDRS to assess non-motor symptoms after STN DBS for Parkinson's disease.

    Science.gov (United States)

    Jafari, Nickey; Pahwa, Rajesh; Nazzaro, Jules M; Arnold, Paul M; Lyons, Kelly E

    2016-01-01

    To determine if the non-motor sections of the Movement Disorder Society's (MDS) version of the Unified Parkinson's Disease Rating Scale (UPDRS) could supplement the original UPDRS as a patient completed assessment of changes in non-motor symptoms in Parkinson's disease (PD) patients after bilateral subthalamic nucleus (STN) deep brain stimulation (DBS). Thirty PD patients who underwent bilateral STN DBS were assessed using the total UPDRS and the non-motor sections of the MDS-UPDRS prior to surgery and one year following surgery. This study focuses on non-motor symptoms as assessed by Part I of the UPDRS and Part 1A and 1B of the MDS-UPDRS. One year following surgery, no individual non-motor symptoms or the total mentation score of the UPDRS were significantly changed. In comparison, the MDS-UPDRS showed significant improvements in sleep and urinary problems and a trend towards improvement in anxiety, constipation, daytime sleepiness, fatigue and pain. This study provides evidence that the MDS-UPDRS non-motor sections, when completed by the patients, can supplement the original version of the UPDRS as an effective method of measuring changes in non-motor symptoms after DBS. It also reinforces the benefits of bilateral STN DBS on non-motor symptoms of PD.

  16. Incorporating novel approaches in the management of MDS beyond conventional hypomethylating agents.

    Science.gov (United States)

    Odenike, Olatoyosi

    2017-12-08

    In the last decade, the treatment of higher-risk myelodysplastic syndromes (MDS) has revolved around the azanucleosides, azacitidine and decitabine, which at lower doses are postulated to work predominantly via their effects on inhibition of DNA methyltransferases and consequent DNA hypomethylation. For patients who relapse after, or do not respond to, hypomethylating agent therapy, the outcome is dismal, and new agents and approaches that have the potential to alter the natural history of these diseases are desperately needed. Allogeneic stem cell transplant is the only known potentially curative approach in MDS, but its applicability has been limited by the advanced age of patients and attendant comorbidities. There is now an increasing array of new agents under clinical investigation in MDS that aim to exploit our expanding understanding of molecular pathways that are important in the pathogenesis of MDS. This review focuses on a critical appraisal of novel agents being evaluated in higher-risk MDS that go beyond the conventional hypomethylating agent therapies approved by the US Food and Drug Administration. © 2016 by The American Society of Hematology. All rights reserved.

  17. [TOPICS-MDS: a versatile resource for generating scientific and social knowledge for elderly care].

    Science.gov (United States)

    van den Brink, Danielle; Lutomski, Jennifer E; Qin, Li; den Elzen, Wendy P J; Kempen, Gertrudis I J M; Krabbe, Paul F M; Steyerberg, Ewout W; Muntinga, Maaike; Moll van Charante, Eric P; Bleijenberg, Nienke; Olde Rikkert, Marcel G M; Melis, René J F

    2015-04-01

    Developed as part of the National Care for the Elderly Programme (NPO), TOPICS-MDS is a uniform, national database on the health and wellbeing of the older persons and caregivers who participated in NPO-funded projects. TOPICS-MDS Consortium has gained extensive experience in constructing a standardized questionnaire to collect relevant health care data on quality of life, health services utilization, and informal care use. A proactive approach has been undertaken not only to ensure the standardization and validation of instruments but also the infrastructure for external data requests. Efforts have been made to promote scientifically and socially responsible use of TOPICS-MDS; data has been available for secondary use since early 2014. Through this data sharing initiative, researchers can explore health issues in a broader framework which may have not been possible within individual NPO projects; this broader framework is highly relevant for influencing health policy. In this article, we provide an overview of the development and on-going progress of TOPICS-MDS. We further describe how information derived from TOPICS-MDS can be applied to facilitate future scientific innovations and public health initiatives to improve care for frail older persons and their caregivers.

  18. Mutational profiling in patients with MDS: ready for every-day use in the clinic?

    Science.gov (United States)

    Bacher, Ulrike; Kohlmann, Alexander; Haferlach, Torsten

    2015-03-01

    Multiple recurrent somatic mutations were identified in the majority of patients with myelodysplastic syndromes (MDS), but investigating the broad spectrum of molecular markers in MDS exceeds many laboratories' capacity when traditional molecular techniques are used. High-throughput second generation sequencing (=next-generation sequencing, NGS) has proven to be applicable for comprehensive biomarker mutation analyses allowing to increase diagnostic sensitivity and accuracy and to improve risk stratification and prognostication in addition to cytomorphology and cytogenetic analysis in patients with MDS. Amplicon deep-sequencing enables comprehensive biomarker analysis in a multitude of patients per investigation in an acceptable turn-around time and at affordable costs. Comprehensive myeloid marker panels were successfully introduced into diagnostic practice. Therefore, molecular mutation analysis is ready for use in all patients with suspected MDS, may contribute to risk stratification in possible candidates for allogeneic stem cell transplantation, and should become an integral part of clinical research studies in MDS patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. The burden of breast cancer in Italy: mastectomies and quadrantectomies performed between 2001 and 2008 based on nationwide hospital discharge records

    Directory of Open Access Journals (Sweden)

    Piscitelli Prisco

    2012-11-01

    Full Text Available Abstract Background Where population coverage is limited, the exclusive use of Cancer Registries might limit ascertainment of incident cancer cases. We explored the potentials of Nationwide hospital discharge records (NHDRs to capture incident breast cancer cases in Italy. Methods We analyzed NHDRs for mastectomies and quadrantectomies performed between 2001 and 2008. The average annual percentage change (AAPC and related 95% Confidence Interval (CI in the actual number of mastectomies and quadrantectomies performed during the study period were computed for the full sample and for subgroups defined by age, surgical procedure, macro-area and singular Region. Re-admissions of the same patients were separately presented. Results The overall number of mastectomies decreased, with an AAPC of −2.1% (−2.3 -1.8. This result was largely driven by the values observed for women in the 45 to 64 and 65 to 74 age subgroups (−3.0%, -3.4 -3.6 and −3.3%, -3.8 -2.8, respectively. We observed no significant reduction in mastectomies for women in the remaining age groups. Quadrantectomies showed an overall +4.7 AAPC (95%CI:4.5–4.9, with no substantial differences by age. Analyses by geographical area showed a remarkable decrease in mastectomies, with inter-regional discrepancies possibly depending upon variability in mammography screening coverage and adherence. Quadrantectomies significantly increased, with Southern Regions presenting the highest average rates. Data on repeat admissions within a year revealed a total number of 46,610 major breast surgeries between 2001 and 2008, with an overall +3.2% AAPC (95%CI:2.8-3.6. Conclusions In Italy, NHDRs might represent a valuable supplemental data source to integrate Cancer Registries in cancer surveillance.

  20. The emerging role of immune checkpoint based approaches in AML and MDS.

    Science.gov (United States)

    Boddu, Prajwal; Kantarjian, Hagop; Garcia-Manero, Guillermo; Allison, James; Sharma, Padmanee; Daver, Naval

    2018-04-01

    The development of immune checkpoint inhibitors represents a major breakthrough in the field of cancer therapeutics. Pursuant to their success in melanoma and numerous solid tumor malignancies, these agents are being investigated in hematological malignancies including acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). Although AML/MDS have traditionally been considered to be less immunogenic than solid tumor malignancies, recent pre-clinical models suggest a therapeutic role for immune checkpoint inhibition in these diseases. CTLA-4 inhibition may be especially effective in treating late post-allogeneic stem cell transplant relapse of AML in patients with limited or no graft versus host disease. Immune checkpoint inhibition, specifically PD-1 inhibition, demonstrated limited single agent efficacy in patients with relapsed AML and with MDS post-hypomethylating therapy. Rationally designed combinations of PD-1 inhibitors with standard anti-leukemic therapy are needed. Hypomethylating agents such as azacitidine, up-regulate PD-1, PD-L1, and PD-L2 in patients with AML/MDS and up-regulation of these genes was associated with the emergence of resistance. The combination of azacitidine and PD-1/PD-L1 inhibition may be a potential mechanism to prevent or overcome resistance to 5-azacitidine. A number of such combinations are being evaluated in clinical trials with early encouraging results. Immune checkpoint inhibition is also an attractive option to improve relapse-free survival or eliminate minimal residual disease post induction and consolidation by enhancing T-cell surveillance in patients with high-risk AML. The ongoing clinical trials with checkpoint inhibitors in AML/MDS will improve our understanding of the immunobiology of these diseases and guide us to the most appropriate application of these agents in the therapy of AML/MDS.

  1. Parkinson's disease severity levels and MDS-Unified Parkinson's Disease Rating Scale.

    Science.gov (United States)

    Martínez-Martín, Pablo; Rodríguez-Blázquez, Carmen; Mario Alvarez; Arakaki, Tomoko; Arillo, Víctor Campos; Chaná, Pedro; Fernández, William; Garretto, Nélida; Martínez-Castrillo, Juan Carlos; Rodríguez-Violante, Mayela; Serrano-Dueñas, Marcos; Ballesteros, Diego; Rojo-Abuin, Jose Manuel; Chaudhuri, Kallol Ray; Merello, Marcelo

    2015-01-01

    Severity of PD is usually assessed by means of the motor and disability-based Hoehn and Yahr staging (HY), or clinician and patient global perceptions. Scores of more detailed assessments, as the MDS-UPDRS, have not been translated to a grading that allows assignment of score sections to severity levels. The objective of the present study is to determine cut-off points for PD severity levels based on the MDS-UPDRS. International, observational study. Applied assessments were: HY, MDS-UPDRS, Clinical Impression for Severity Index, and Clinical and Patient Global Impression of Severity. The coincidence in severity level (mild, moderate, severe) of at least two clinical classifications plus the patient's gradation was considered "the criterion of severity". Cut-off values for each MDS-UPDRS subscale was determined by triangulation of: 1) percentile 90 of the subscale total score; 2) receiver operating characteristic (ROC) analysis; and 3) ordinal logistic regression (OLR) model. Sample was composed of 452 consecutive PD patients without dementia, 55.3% males, age 65.1 ± 10.7 years and PD duration 8.7 ± 6.3 years. All HY stages were represented. The "criterion", classified 275 patients (60.8% of the sample) as: mild PD, 149 (54.2%); moderate, 82 (29.8%); and severe, 44 (16%). The following MDS-UPDRS cut-off points between mild/moderate and moderate/severe levels were found: Part 1: 10/11 and 21/22; Part 2: 12/13 and 29/30; Part 3: 32/33 and 58/59; and Part 4: 4/5 and 12/13. Cut-off points to classify PD patients as mild, moderate, or severe on the basis of their MDS-UPDRS scores are proposed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. SF3B1-initiating mutations in MDS-RSs target lymphomyeloid hematopoietic stem cells.

    Science.gov (United States)

    Mortera-Blanco, Teresa; Dimitriou, Marios; Woll, Petter S; Karimi, Mohsen; Elvarsdottir, Edda; Conte, Simona; Tobiasson, Magnus; Jansson, Monika; Douagi, Iyadh; Moarii, Matahi; Saft, Leonie; Papaemmanuil, Elli; Jacobsen, Sten Eirik W; Hellström-Lindberg, Eva

    2017-08-17

    Mutations in the RNA splicing gene SF3B1 are found in >80% of patients with myelodysplastic syndrome with ring sideroblasts (MDS-RS). We investigated the origin of SF3B1 mutations within the bone marrow hematopoietic stem and progenitor cell compartments in patients with MDS-RS. Screening for recurrently mutated genes in the mononuclear cell fraction revealed mutations in SF3B1 in 39 of 40 cases (97.5%), combined with TET2 and DNMT3A in 11 (28%) and 6 (15%) patients, respectively. All recurrent mutations identified in mononuclear cells could be tracked back to the phenotypically defined hematopoietic stem cell (HSC) compartment in all investigated patients and were also present in downstream myeloid and erythroid progenitor cells. While in agreement with previous studies, little or no evidence for clonal ( SF3B1 mutation) involvement could be found in mature B cells, consistent involvement at the pro-B-cell progenitor stage was established, providing definitive evidence for SF3B1 mutations targeting lymphomyeloid HSCs and compatible with mutated SF3B1 negatively affecting lymphoid development. Assessment of stem cell function in vitro as well as in vivo established that only HSCs and not investigated progenitor populations could propagate the SF3B1 mutated clone. Upon transplantation into immune-deficient mice, SF3B1 mutated MDS-RS HSCs differentiated into characteristic ring sideroblasts, the hallmark of MDS-RS. Our findings provide evidence of a multipotent lymphomyeloid HSC origin of SF3B1 mutations in MDS-RS patients and provide a novel in vivo platform for mechanistically and therapeutically exploring SF3B1 mutated MDS-RS. © 2017 by The American Society of Hematology.

  3. Time-dependent changes in mortality and transformation risk in MDS.

    Science.gov (United States)

    Pfeilstöcker, Michael; Tuechler, Heinz; Sanz, Guillermo; Schanz, Julie; Garcia-Manero, Guillermo; Solé, Francesc; Bennett, John M; Bowen, David; Fenaux, Pierre; Dreyfus, Francois; Kantarjian, Hagop; Kuendgen, Andrea; Malcovati, Luca; Cazzola, Mario; Cermak, Jaroslav; Fonatsch, Christa; Le Beau, Michelle M; Slovak, Marilyn L; Levis, Alessandro; Luebbert, Michael; Maciejewski, Jaroslaw; Machherndl-Spandl, Sigrid; Magalhaes, Silvia M M; Miyazaki, Yasushi; Sekeres, Mikkael A; Sperr, Wolfgang R; Stauder, Reinhard; Tauro, Sudhir; Valent, Peter; Vallespi, Teresa; van de Loosdrecht, Arjan A; Germing, Ulrich; Haase, Detlef; Greenberg, Peter L

    2016-08-18

    In myelodysplastic syndromes (MDSs), the evolution of risk for disease progression or death has not been systematically investigated despite being crucial for correct interpretation of prognostic risk scores. In a multicenter retrospective study, we described changes in risk over time, the consequences for basal prognostic scores, and their potential clinical implications. Major MDS prognostic risk scoring systems and their constituent individual predictors were analyzed in 7212 primary untreated MDS patients from the International Working Group for Prognosis in MDS database. Changes in risk of mortality and of leukemic transformation over time from diagnosis were described. Hazards regarding mortality and acute myeloid leukemia transformation diminished over time from diagnosis in higher-risk MDS patients, whereas they remained stable in lower-risk patients. After approximately 3.5 years, hazards in the separate risk groups became similar and were essentially equivalent after 5 years. This fact led to loss of prognostic power of different scoring systems considered, which was more pronounced for survival. Inclusion of age resulted in increased initial prognostic power for survival and less attenuation in hazards. If needed for practicability in clinical management, the differing development of risks suggested a reasonable division into lower- and higher-risk MDS based on the IPSS-R at a cutoff of 3.5 points. Our data regarding time-dependent performance of prognostic scores reflect the disparate change of risks in MDS subpopulations. Lower-risk patients at diagnosis remain lower risk whereas initially high-risk patients demonstrate decreasing risk over time. This change of risk should be considered in clinical decision making. © 2016 by The American Society of Hematology.

  4. Prognostic classification of MDS is improved by the inclusion of FISH panel testing with conventional cytogenetics.

    Science.gov (United States)

    Kokate, Prajakta; Dalvi, Rupa; Koppaka, Neeraja; Mandava, Swarna

    2017-10-01

    Cytogenetics is a critical independent prognostic factor in myelodysplastic syndromes (MDS). Conventional cytogenetics (CC) and Fluorescence in situ hybridization (FISH) Panel Testing are extensively used for the prognostic stratification of MDS, although the FISH test is not yet a bona fide component of the International Prognostic Scoring System (IPSS). The present study compares the utility of CC and FISH to detect chromosomal anomalies and in prognostic categorization. GTG-Banding and FISH Panel Testing specifically for -5/-5q, -7/-7q, +8 and -20q was performed on whole blood or bone marrow samples from 136 patients with MDS. Chromosomal anomalies were found in 40 cases by CC, including three novel translocations. FISH identified at least one anomaly in 54/136 (39.7%) cases. More than one anomaly was found in 18/54 (33.3%) cases, therefore, overall FISH identified 75 anomalies of which 32 (42.6%) were undetected by CC. FISH provided additional information in cases with CC failure and in cases with a normal karyotype. Further, in ten cases with an abnormal karyotype, FISH could identify additional anomalies, increasing the number of abnormalities per patient. Although CC is the gold standard in the cytogenetic profiling of MDS, FISH has proven to be an asset in identifying additional abnormalities. The number of anomalies per patient can predict the prognosis in MDS and hence, FISH contributed towards prognostic re-categorization. The FISH Panel testing should be used as an adjunct to CC, irrespective of the adequacy of the number of metaphases in CC, as it improves the prognostic classification of MDS. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. [Changes of CD34(+) and CD71(+)CD45(-) cell levels in bone marrow of MDS and AA patients].

    Science.gov (United States)

    Yan, Zhen-Yu; Tian, Xu; Li, Ying; Yang, Mei-Rong; Zhang, Song; Wang, Xie-Ming; Zhang, Hai-Xia; Cheng, Nai-Yao

    2014-04-01

    This study was aimed to investigate the changes of CD34(+) and CD71(+)CD45(-) cell levels in MDS and AA patients. A total of 25 cases MDS and 43 cases of AA (18 cases SAA and 25 cases of NSAA) from January 2010 to October 2013 in the Department of Hematology, affiliated hospital of Hebei United University were enrolled in this study. The complete blood count, bone marrow smears, bone marrow biopsy, karyotype analysis and bone marrow blood cell immune genotyping (mainly the proportion of CD34(+) cells, CD71(+)CD45(-) cells in nucleated cells) were carried out for all patients; the changes of CD34(+) and CD71(+)CD45(-) cell levels in patients with MDS and AA (SAA NSAA) were compared; the differences of white blood cell count, platelet count and hemoglobin concentration in patients with count of CD71(+)CD45(-) ≥ 15% or MDS group was higher than that in AA (NSAA and SAA) group (P MDS group was higher than that in SAA (P MDS group. In MDS group with CD71(+)CD45(-) ≥ 15%, the platelet count was significantly higher than that in NSAA group (P MDS and NSAA group with CD71(+)CD45(-) 0.05). It is concluded that the count of CD34(+) cells in MDS patients is significantly higher than that in AA and SAA patients. The count of CD71(+)CD45(-) cells in MDS group is significantly higher than that of SAA group. The platelet count in MDS patients with CD71(+)CD45(-) cells ≥ 15% is significantly higher than that of the NSAA group.

  6. Gene expression profiling in MDS and AML: potential and future avenues

    DEFF Research Database (Denmark)

    Theilgaard-Mönch, K; Boultwood, J; Ferrari, S

    2011-01-01

    Today, the classification systems for myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) already incorporate cytogenetic and molecular genetic aberrations in an attempt to better reflect disease biology. However, in many MDS/AML patients no genetic aberrations have been identified yet...... with regard to diagnosis, prediction of clinical outcome, discovery of novel subclasses and identification of novel therapeutic targets and novel drugs. As many challenges remain ahead, we discuss the pitfalls of this technology and its potential including future integrative studies with other genomics...

  7. An international consortium proposal of uniform response criteria for myelodysplastic/myeloproliferative neoplasms (MDS/MPN) in adults.

    Science.gov (United States)

    Savona, Michael R; Malcovati, Luca; Komrokji, Rami; Tiu, Ramon V; Mughal, Tariq I; Orazi, Attilio; Kiladjian, Jean-Jacques; Padron, Eric; Solary, Eric; Tibes, Raoul; Itzykson, Raphael; Cazzola, Mario; Mesa, Ruben; Maciejewski, Jaroslaw; Fenaux, Pierre; Garcia-Manero, Guillermo; Gerds, Aaron; Sanz, Guillermo; Niemeyer, Charlotte M; Cervantes, Francisco; Germing, Ulrich; Cross, Nicholas C P; List, Alan F

    2015-03-19

    Myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN) are hematologically diverse stem cell malignancies sharing phenotypic features of both myelodysplastic syndromes and myeloproliferative neoplasms. There are currently no standard treatment recommendations for most adult patients with MDS/MPN. To optimize efforts to improve the management and disease outcomes, it is essential to identify meaningful clinical and biologic end points and standardized response criteria for clinical trials. The dual dysplastic and proliferative features in these stem cell malignancies define their uniqueness and challenges. We propose response assessment guidelines to harmonize future clinical trials with the principal objective of establishing suitable treatment algorithms. An international panel comprising laboratory and clinical experts in MDS/MPN was established involving 3 independent academic MDS/MPN workshops (March 2013, December 2013, and June 2014). These recommendations are the result of this collaborative project sponsored by the MDS Foundation. © 2015 by The American Society of Hematology.

  8. Mouse Drawer System (MDS): An autonomous hardware for supporting mice space research

    Science.gov (United States)

    Liu, Y.; Biticchi, R.; Alberici, G.; Tenconi, C.; Cilli, M.; Fontana, V.; Cancedda, R.; Falcetti, G.

    2005-08-01

    For the scientific community the ability of flying mice under weightless conditions in space, compared to other rodents, offers many valuable advantages. These include the option of testing a wide range of wild-type and mutant animals, an increased animal number for flight, and a reduced demand on shuttle resources and crew time. In this study, we describe a spaceflight hardware for mice, the Mouse Drawer System (MDS). MDS can interface with Space Shuttle middeck and International Space Station Express Rack. It consists of Mice Chamber, Liquid Handling Subsystem, Food Delivery Subsystem, Air Conditioning Subsystem, Illumination Subsystem, Observation Subsystem and Payload Control Unit. It offers single or paired containment for 6-8 mice with a mean weight of 40 grams/mouse for a period of up to 3 months. Animal tests were conducted in a MDS breadboard to validate the biocompatibility of various subsystems. Mice survived in all tests of short and long duration. Results of blood parameters, histology and air/waste composition analysis showed that MDS subsystems meet the NIH guidelines for temperature, humidity, food and water access, air quality, odour and waste management.

  9. Shoulder replacement - discharge

    Science.gov (United States)

    Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; Arthroplasty - shoulder - discharge

  10. Focal Adhesion Kinase as a Potential Target in AML and MDS.

    Science.gov (United States)

    Carter, Bing Z; Mak, Po Yee; Wang, Xiangmeng; Yang, Hui; Garcia-Manero, Guillermo; Mak, Duncan H; Mu, Hong; Ruvolo, Vivian R; Qiu, Yihua; Coombes, Kevin; Zhang, Nianxiang; Ragon, Brittany; Weaver, David T; Pachter, Jonathan A; Kornblau, Steven; Andreeff, Michael

    2017-06-01

    Although overexpression/activation of focal adhesion kinase (FAK) is widely known in solid tumors to control cell growth, survival, invasion, metastasis, gene expression, and stem cell self-renewal, its expression and function in myeloid leukemia are not well investigated. Using reverse-phase protein arrays in large cohorts of newly diagnosed acute myeloid leukemia (AML) and myeloid dysplastic syndrome (MDS) samples, we found that high FAK expression was associated with unfavorable cytogenetics ( P = 2 × 10 -4 ) and relapse ( P = 0.02) in AML. FAK expression was significantly lower in patients with FLT3 -ITD ( P = 0.0024) or RAS ( P = 0.05) mutations and strongly correlated with p-SRC and integrinβ3 levels. FAK protein levels were significantly higher in CD34 + ( P = 5.42 × 10 -20 ) and CD34 + CD38 - MDS ( P = 7.62 × 10 -9 ) cells compared with normal CD34 + cells. MDS patients with higher FAK in CD34 + cells tended to have better overall survival ( P = 0.05). FAK expression was significantly higher in MDS patients who later transformed to compared with those who did not transform to AML and in AML patients who transformed from MDS compared with those with de novo AML. Coculture with mesenchymal stromal cells (MSC) increased FAK expression in AML cells. Inhibition of FAK decreased MSC-mediated adhesion/migration and viability of AML cells and prolonged survival in an AML xenograft murine model. Our results suggest that FAK regulates leukemia-stromal interactions and supports leukemia cell survival; hence, FAK is a potential therapeutic target in myeloid leukemia. Mol Cancer Ther; 16(6); 1133-44. ©2017 AACR . ©2017 American Association for Cancer Research.

  11. Development of a Minimum Data Set (MDS) for C-Section Anesthesia Information Management System (AIMS).

    Science.gov (United States)

    Sheykhotayefeh, Mostafa; Safdari, Reza; Ghazisaeedi, Marjan; Khademi, Seyed Hossein; Seyed Farajolah, Seyedeh Sedigheh; Maserat, Elham; Jebraeily, Mohamad; Torabi, Vahid

    2017-04-01

    Caesarean section, also known as C-section, is a very common procedure in the world. Minimum data set (MDS) is defined as a set of data elements holding information regarding a series of target entities to provide a basis for planning, management, and performance evaluation. MDS has found a great use in health care information systems. Also, it can be considered as a basis for medical information management and has shown a great potential for contributing to the provision of high quality care and disease control measures. The principal aim of this research was to determine MDS and required capabilities for Anesthesia information management system (AIMS) in C-section in Iran. Data items collected from several selected AIMS were studied to establish an initial set of data. The population of this study composed of 115 anesthesiologists was asked to review the proposed data elements and score them in order of importance by using a five-point Likert scale. The items scored as important or highly important by at least 75% of the experts were included in the final list of minimum data set. Overall 8 classes of data (consisted of 81 key data elements) were determined as final set. Also, the most important required capabilities were related to airway management and hypertension and hypotension management. In the development of information system (IS) based on MDS and identification, because of the broad involvement of users, IS capabilities must focus on the users' needs to form a successful system. Therefore, it is essential to assess MDS watchfully by considering the planned uses of data. Also, IS should have essential capabilities to meet the needs of its users.

  12. Valuation of transfusion-free living in MDS: results of health utility interviews with patients

    Directory of Open Access Journals (Sweden)

    Lübbert Michael

    2009-09-01

    Full Text Available Abstract Background This study measured how myelodysplastic syndrome (MDS patients value transfusion independence (TI, reduced transfusions (RT and transfusion-dependence (TD using health utility assessment methodology. Methods 47 MDS patients were interviewed, US (n = 8, France (n = 9, Germany (n = 9 and the UK (n = 21, to elicit the utility value of TI, RT and TD. Health states were developed based on literature; patient forum discussions; and were validated by a hematologist. Face-to-face interviews used the feeling thermometer Visual Analogue Scale (VAS and the Time Trade-Off (TTO method to value the health states on a 0 (dead to 1 (perfect health scale. Socio-demographic, clinical, and quality-of-life (EQ-5D characteristics were surveyed to describe the patient sample. Results and Discussion The mean age was 67 years (range: 29-83; 45% male, 70% retired; 40% had secondary/high school education, or higher (32%, and 79% lived with family, a partner or spouse, or friends. The mean time from MDS diagnosis was 5 years (range:1-23. Most patients (87% received previous transfusions and 49% had received a transfusion in the last 3 months. Mean EQ-5D index score was 0.78; patients reported at least some problem with mobility (45%, usual activities (40%, pain/discomfort (47%, and anxiety/depression (34%. Few patients had difficulty understanding the VAS (n = 3 and TTO (n = 4 exercises. Utility scores for TI were higher than for RT (0.84 vs. 0.77; p Conclusion Patients value TI, suggesting an important role for new treatments aiming to achieve greater TI in MDS. These results can be used in preference-based health economic evaluation of new MDS treatments, such as in future cost-utility studies.

  13. MDS shows a higher expression of hTERT and alternative splice variants in unactivated T-cells.

    Science.gov (United States)

    Dong, Wen; Wu, Lei; Sun, Houfang; Ren, Xiubao; Epling-Burnette, Pearlie K; Yang, Lili

    2016-11-01

    Telomere instability and telomerase reactivation are believed to play an important role in the development of myelodysplastic syndromes (MDS). Abnormal enzymatic activity of human telomerase reverse transcriptase (hTERT), and its alternative splice variants have been reported to account for deregulated telomerase function in many cancers. In this study, we aim to compare the differences in expression of hTERT and hTERT splice variants, as well as telomere length and telomerase activity in unstimulated T-cells between MDS subgroups and healthy controls. Telomere length in MDS cases was significantly shorter than controls (n = 20, pMDS using World Health Organization classification (WHO subgroups versus control: RARS, p= 0.009; RCMD, p=0.0002; RAEB1/2, p=0.004, respectively) and the International Prognostic Scoring System (IPSS subgroups: Low+Int-1, pMDS patients (n=20) had significantly higher telomerase activity (p=0.002), higher total hTERT mRNA levels (p=0.001) and hTERT α+β- splice variant expression (pMDS (r=0.58, p=0.007). This data is in sharp contrast to data published previously by our group showing a reduction in telomerase and hTERT mRNA in MDS T-cells after activation. In conclusion, this study provides additional insight into hTERT transcript patterns and activity in peripheral T-cells of MDS patients. Additional studies are necessary to better understand the role of this pathway in MDS development and progression.

  14. Validity of the RAI-MDS for ascertaining diabetes and comorbid conditions in long-term care facility residents.

    Science.gov (United States)

    Lix, Lisa M; Yan, Lin; Blackburn, David; Hu, Nianping; Schneider-Lindner, Verena; Teare, Gary F

    2014-01-15

    This study assessed the validity of the Resident Assessment Instrument Minimum Data Set (RAI-MDS) Version 2.0 for diagnoses of diabetes and comorbid conditions in residents of long-term care facilities (LTCFs). Hospital inpatient, outpatient physician billing, RAI-MDS, and population registry data for 1997 to 2011 from Saskatchewan, Canada were used to ascertain cases of diabetes and 12 comorbid conditions. Prevalence estimates were calculated for both RAI-MDS and administrative health data. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated using population-based administrative health data as the validation data source. Cohen's κ was used to estimate agreement between the two data sources. 23,217 LTCF residents were in the diabetes case ascertainment cohort. Diabetes prevalence was 25.3% in administrative health data and 21.9% in RAI-MDS data. Overall sensitivity of a RAI-MDS diabetes diagnoses was 0.79 (95% CI: 0.79, 0.80) and the PPV was 0.92 (95% CI: 0.91, 0.92), when compared to administrative health data. Sensitivity of the RAI-MDS for ascertaining comorbid conditions ranged from 0.21 for osteoporosis to 0.92 for multiple sclerosis; specificity was high for most conditions. RAI-MDS clinical assessment data are sensitive to ascertain diabetes cases in LTCF populations when compared to administrative health data. For many comorbid conditions, RAI-MDS data have low validity when compared to administrative data. Risk-adjustment measures based on these comorbidities might not produce consistent results for RAI-MDS and administrative health data, which could affect the conclusions of studies about health outcomes and quality of care across facilities.

  15. PP2A: The Achilles Heal in MDS with 5q Deletion

    Directory of Open Access Journals (Sweden)

    David eSallman

    2014-09-01

    Full Text Available Myelodysplastic syndromes (MDS represent a hematologically diverse group of myeloid neoplasms, however, one subtype characterized by an isolated deletion of chromosome 5q (del(5q is pathologically and clinically distinct. Patients with del(5q MDS share biological features that account for the profound hypoplastic anemia and unique sensitivity to treatment with lenalidomide. Ineffective erythropoiesis in del(5q MDS arises from allelic deletion of the ribosomal processing S-14 (RPS14 gene, which leads to MDM2 sequestration with consequent p53 activation and erythroid cell death. Since its approval in 2005, lenalidomide has changed the natural course of the disease. Patients who achieve transfusion independence and/or a cytogenetic response with lenalidomide have a decreased risk of progression to AML and an improved overall survival compared to non-responders. Elucidation of the mechanisms of action of lenalidomide in del(5q MDS has advanced therapeutic strategies for this disease. The selective cytotoxicity of lenalidomide in del(5q clones derives from inhibition of a haplodeficient phosphatase whose catalytic domain is encoded within the common deleted region on chromosome 5q, i.e., protein phosphatase 2A (PP2Acα. PP2A is a highly conserved, dual specificity phosphatase that plays an essential role in regulation of the G2/M checkpoint. Inhibition of PP2Acα results in cell cycle arrest and apoptosis in del(5q cells. Targeted knockdown of PP2Acα using siRNA is sufficient to sensitize non-del(5q clones to lenalidomide. Through its inhibitory effect on PP2A, lenalidomide stabilizes MDM2 to restore p53 degradation in erythroid precursors, with subsequent arrest in G2/M. Unfortunately, the majority of patients with del(5q MDS develop resistance to lenalidomide over time associated with PP2Acα overexpression. Targeted inhibition of PP2A with a more potent inhibitor has emerged as an attractive therapeutic approach for patients with del(5q MDS.

  16. Studies of environmental radioactivity in Cumbria. Part 6. The chronology of discharges of caesium-137, plutonium and americium-241 from BNFL Sellafield, as recorded in lake sediments

    Energy Technology Data Exchange (ETDEWEB)

    Eakins, J D; Cambray, R S

    1985-04-01

    A study has been made of the radionuclide content of lake sediments from Cumbria in order to determine the history of discharges of /sup 137/Cs and actinides from the Sellafield works of British Nuclear Fuels plc (BNFL). Sediment cores have been taken from Ullswater and Grasmere, which are remote from Sellafield, in order to establish the behaviour of nuclear weapon fallout nuclides. Cores have also been taken from Barfield Tarn, which is 19 km SE of Sellafield but close to the sea, and from Ponsonby and Harnsey Moss Tarns, close to Sellafield. All sediments were analysed for /sup 137/Cs and sup(239+240)Pu. Additional measurements of /sup 238/Pu and /sup 241/Am were made on samples from the closer tarns. The sediment cores were dated by the /sup 210/Pb method and, where appropriate, by the /sup 137/Cs technique also. The amounts of /sup 137/Cs and sup(239+240)Pu in sediments from Barfield Tarn could be accounted for by fallout from nuclear weapons, although the levels of /sup 241/Am were marginally greater. However in Harnsey Moss Tarn the levels of actinides indicated that they were derived mainly from material originally discharged to sea from Sellafield. Sediment from Ponsonby Tarn contained material derived mainly from discharges to atmosphere.

  17. CD16xCD33 bispecific killer cell engager (BiKE) activates NK cells against primary MDS and MDSC CD33+ targets.

    Science.gov (United States)

    Gleason, Michelle K; Ross, Julie A; Warlick, Erica D; Lund, Troy C; Verneris, Michael R; Wiernik, Andres; Spellman, Stephen; Haagenson, Michael D; Lenvik, Alexander J; Litzow, Mark R; Epling-Burnette, Pearlie K; Blazar, Bruce R; Weiner, Louis M; Weisdorf, Daniel J; Vallera, Daniel A; Miller, Jeffrey S

    2014-05-08

    Myelodysplastic syndromes (MDS) are stem cell disorders that can progress to acute myeloid leukemia. Although hematopoietic cell transplantation can be curative, additional therapies are needed for a disease that disproportionally afflicts the elderly. We tested the ability of a CD16xCD33 BiKE to induce natural killer (NK) cell function in 67 MDS patients. Compared with age-matched normal controls, CD7(+) lymphocytes, NK cells, and CD16 expression were markedly decreased in MDS patients. Despite this, reverse antibody-dependent cell-mediated cytotoxicity assays showed potent degranulation and cytokine production when resting MDS-NK cells were triggered with an agonistic CD16 monoclonal antibody. Blood and marrow MDS-NK cells treated with bispecific killer cell engager (BiKE) significantly enhanced degranulation and tumor necrosis factor-α and interferon-γ production against HL-60 and endogenous CD33(+) MDS targets. MDS patients had a significantly increased proportion of immunosuppressive CD33(+) myeloid-derived suppressor cells (MDSCs) that negatively correlated with MDS lymphocyte populations and CD16 loss on NK cells. Treatment with the CD16xCD33 BiKE successfully reversed MDSC immunosuppression of NK cells and induced MDSC target cell lysis. Lastly, the BiKE induced optimal MDS-NK cell function irrespective of disease stage. Our data suggest that the CD16xCD33 BiKE functions against both CD33(+) MDS and MDSC targets and may be therapeutically beneficial for MDS patients.

  18. Meta-Analytical Online Repository of Gene Expression Profiles of MDS Stem Cells

    Science.gov (United States)

    2015-12-01

    lymphoid cell percentages in these samples. We observed that most of the MDS samples had lymphoid and neutrophil percentages that were in the normal...pathways involved in chemokine signaling, cytokine-cytokine receptor interaction, innate immunity signaling, hematopoietic cell lineage regulation, and...transcription factors are important for survival of cancer stem cells .2,34-36 IL8 is also an important regulator of innate immunity. Recent data have shown

  19. Connect MDS/AML: design of the myelodysplastic syndromes and acute myeloid leukemia disease registry, a prospective observational cohort study.

    Science.gov (United States)

    Steensma, David P; Abedi, Medrdad; Bejar, Rafael; Cogle, Christopher R; Foucar, Kathryn; Garcia-Manero, Guillermo; George, Tracy I; Grinblatt, David; Komrokji, Rami; Ma, Xiaomei; Maciejewski, Jaroslaw; Pollyea, Daniel A; Savona, Michael R; Scott, Bart; Sekeres, Mikkael A; Thompson, Michael A; Swern, Arlene S; Nifenecker, Melissa; Sugrue, Mary M; Erba, Harry

    2016-08-19

    Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are myeloid neoplasms in which outgrowth of neoplastic clones disrupts normal hematopoiesis. Some patients with unexplained persistent cytopenias may not meet minimal diagnostic criteria for MDS but an alternate diagnosis is not apparent; the term idiopathic cytopenia of undetermined significance (ICUS) has been used to describe this state. MDS and AML occur primarily in older patients who are often treated outside the clinical trial setting. Consequently, our understanding of the patterns of diagnostic evaluation, management, and outcomes of these patients is limited. Furthermore, there are few natural history studies of ICUS. To better understand how patients who have MDS, ICUS, or AML are managed in the routine clinical setting, the Connect MDS/AML Disease Registry, a multicenter, prospective, observational cohort study of patients newly diagnosed with these conditions has been initiated. The Connect MDS/AML Disease Registry will capture diagnosis, risk assessment, treatment, and outcomes data for approximately 1500 newly diagnosed patients from approximately 150 community and academic sites in the United States in 4 cohorts: (1) lower-risk MDS (International Prognostic Scoring System [IPSS] low and intermediate-1 risk), with and without del(5q); (2) higher-risk MDS (IPSS intermediate-2 and high risk); (3) ICUS; and (4) AML in patients aged ≥ 55 years (excluding acute promyelocytic leukemia). Diagnosis will be confirmed by central review. Baseline patient characteristics, diagnostic patterns, treatment patterns, clinical outcomes, health economics outcomes, and patient-reported health-related quality of life will be entered into an electronic data capture system at enrollment and quarterly for 8 years. A tissue substudy to explore the relationship between karyotypes, molecular markers, and clinical outcomes will be conducted, and is optional for patients. The Connect MDS/AML Disease

  20. Limited clinical efficacy of azacitidine in transfusion-dependent, growth factor-resistant, low- and Int-1-risk MDS

    DEFF Research Database (Denmark)

    Holm, Mette; Dybedahl, I; Holm, Mette

    2014-01-01

    This prospective phase II study evaluated the efficacy of azacitidine (Aza)+erythropoietin (Epo) in transfusion-dependent patients with lower-risk myelodysplastic syndrome (MDS). Patients ineligible for or refractory to full-dose Epo+granulocyte colony stimulation factors for >8 weeks and a trans...... patients, but efficacy is limited, toxicity substantial and most responses of short duration. This treatment cannot be generally recommended in lower-risk MDS. Mutational screening revealed a high frequency of mutations....

  1. EVI and MDS/EVI are required for adult intestinal stem cell formation during postembryonic vertebrate development.

    Science.gov (United States)

    Okada, Morihiro; Shi, Yun-Bo

    2018-01-01

    The gene ectopic viral integration site 1 (EVI) and its variant myelodysplastic syndrome 1 (MDS)/EVI encode zinc-finger proteins that have been recognized as important oncogenes in various types of cancer. In contrast to the established role of EVI and MDS/EVI in cancer development, their potential function during vertebrate postembryonic development, especially in organ-specific adult stem cells, is unclear. Amphibian metamorphosis is strikingly similar to postembryonic development around birth in mammals, with both processes taking place when plasma thyroid hormone (T3) levels are high. Using the T3-dependent metamorphosis in Xenopus tropicalis as a model, we show here that high levels of EVI and MDS/EVI are expressed in the intestine at the climax of metamorphosis and are induced by T3. By using the transcription activator-like effector nuclease gene editing technology, we have knocked out both EVI and MDS/EVI and have shown that EVI and MDS/EVI are not essential for embryogenesis and premetamorphosis in X. tropicalis On the other hand, knocking out EVI and MDS/EVI causes severe retardation in the growth and development of the tadpoles during metamorphosis and leads to tadpole lethality at the climax of metamorphosis. Furthermore, the homozygous-knockout animals have reduced adult intestinal epithelial stem cell proliferation at the end of metamorphosis (for the few that survive through metamorphosis) or during T3-induced metamorphosis. These findings reveal a novel role of EVI and/or MDS/EVI in regulating the formation and/or proliferation of adult intestinal adult stem cells during postembryonic development in vertebrates.-Okada, M., Shi, Y.-B. EVI and MDS/EVI are required for adult intestinal stem cell formation during postembryonic vertebrate development. © FASEB.

  2. NIPPLE DISCHARGE

    Directory of Open Access Journals (Sweden)

    T. N. Bukharova

    2008-01-01

    Full Text Available According to the data available in the literature, as high as 50% of women have benign breast tumors frequently accompanied by nip- ple discharge. Nipple discharge may be serous, bloody, purulent, and colostric. The most common causes are breast abscess, injury, drugs, prolactinoma, intraductal pappiloma, ductal ectasia, intraductal cancer (not more than 10%.

  3. The MDS-UPDRS Part II (motor experiences of daily living) resulted useful for assessment of disability in Parkinson's disease.

    Science.gov (United States)

    Rodriguez-Blazquez, Carmen; Rojo-Abuin, Jose Manuel; Alvarez-Sanchez, Mario; Arakaki, Tomoko; Bergareche-Yarza, Alberto; Chade, Anabel; Garretto, Nelida; Gershanik, Oscar; Kurtis, Monica M; Martinez-Castrillo, Juan Carlos; Mendoza-Rodriguez, Amelia; Moore, Henry P; Rodriguez-Violante, Mayela; Singer, Carlos; Tilley, Barbara C; Huang, Jing; Stebbins, Glenn T; Goetz, Christopher G; Martinez-Martin, Pablo

    2013-10-01

    To evaluate the motor experiences of daily living section of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS M-EDL) for assessing disability in PD patients; to determine the association between disability and quality of life; and to identify cut-off score ranges for no, mild, moderate and severe disability with this measure. International, observational, cross-sectional study of 435 PD patients, assessed with: MDS-UPDRS, Hoehn and Yahr staging, Rapid Assessment of Disability Scale, Clinical Impression of Severity Index for PD, Parkinson's Disease Questionnaire-8 and EQ-5D. Descriptive statistics, Spearman's rank correlation coefficients, Kruskal-Wallis test for group comparisons, ordinal logistic regression analysis for setting cut-off values and a step-wise multiple linear regression model were calculated. MDS-UPDRS M-EDL correlated 0.70-0.80 with other disability measures, and -0.46 to 0.74 with quality of life scales. Scores significantly increased with higher disease duration and severity (p MDS-UPDRS nM-EDL section as the main determinant of M-EDL, followed by the rest of MDS-UPDRS sections (explained variance: 59%). MDS-UPDRS M-EDL proved to be useful for assessing disability in PD. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Th17 Cells Exhibit Antitumor Effects in MDS Possibly through Augmenting Functions of CD8+ T Cells.

    Science.gov (United States)

    Li, Jing; Yue, Lanzhu; Wang, Huaquan; Liu, Chunyan; Liu, Hui; Tao, Jinglian; Qi, Weiwei; Wang, Yihao; Zhang, Wei; Fu, Rong; Shao, Zonghong

    2016-01-01

    Th17 cells are a newly found subset of distinct CD4+ Th effector cells' family and are found to play an important role in cancers. Myelodysplastic syndromes (MDS) are a common malignant hematological disease. Here, we showed that both the percentage and the function of Th17 cells were elevated in low-risk MDS while being decreased in high-risk MDS. Levels of upstream molecules of Th17 cells, IL-6 and IL-23, were higher in low-risk MDS but lower in high-risk MDS patients. The abnormal percentage of Th17 cells was closely related to clinical parameters including karyotype, morphologic blast percentage of bone marrow, peripheral absolute neutrophil count, and hemoglobin concentration. Furthermore, expression rates of perforin and granzyme B in BM CD3+CD8+ cells (cytotoxic T lymphocyte, CTL) positively correlated with levels of IL-17 but negatively correlated with BM blast percentage and could be significantly increased after stimulation with human recombinant IL-17 (rhIL-17). Our results suggested that Th17 cells might play an antitumor effect in the pathogenesis of MDS through IL-17/CTL pathway.

  5. A pilot study on the usefulness of peripheral blood flow cytometry for the diagnosis of lower risk myelodysplastic syndromes: the "MDS thermometer".

    Science.gov (United States)

    Aires, Ana; Teixeira, Maria Dos Anjos; Lau, Catarina; Moreira, Cláudia; Spínola, Ana; Mota, Alexandra; Freitas, Inês; Coutinho, Jorge; Lima, Margarida

    2018-01-01

    Immunophenotypic analysis of the bone marrow (BM) cells has proven to be helpful in the diagnosis of Myelodysplastic Syndromes (MDS). However, the usefulness of flow cytometry (FCM) for the detection of myelodysplasia in the peripheral blood (PB) still needs to be investigated. The aim of this pilot study was to evaluate the value of FCM-based PB neutrophil and monocyte immunophenotyping for the diagnosis of lower risk MDS (LR-MDS). We evaluated by 8-color FCM the expression of multiple cell surface molecules (CD10, CD11b, CD11c, CD13, CD14, CD15, CD16, CD34, CD45, CD56, CD64 and HLA-DR) in PB neutrophils and monocytes from a series of 14 adult LR-MDS patients versus 14 normal individuals. Peripheral blood neutrophils from patients with LR-MDS frequently had low forward scatter (FSC) and side scatter (SSC) values and low levels of CD11b, CD11c, CD10, CD16, CD13 and CD45 expression, in that order, as compared to normal neutrophils. In addition, patients with LR-MDS commonly display a higher fraction of CD14 + CD56 + and a lower fraction of CD14 + CD16 + monocytes in the PB. Based on these results, we proposed an immunophenotyping score based on which PB samples from patients with LR-MDS could be distinguished from normal PB samples with a sensitivity 93% and a specificity of 100%. In addition, we used this score to construct the MDS Thermometer, a screening tool for detection and monitoring of MDS in the PB in clinical practice. Peripheral blood neutrophil and monocyte immunophenotyping provide useful information for the diagnosis of LR-MDS, as a complement to cytomorphology. If validated by subsequent studies in larger series of MDS patients and extended to non-MDS patients with cytopenias, our findings may improve the diagnostic assessment and avoid invasive procedures in selected groups of MDS patients.

  6. Ileostomy - discharge

    Science.gov (United States)

    ... dried fruits (such as raisins), mushrooms, chunky relishes, coconut, and some Chinese vegetables. Tips for when no ... ask your doctor Living with your ileostomy Low-fiber diet Small bowel resection - discharge Total colectomy or ...

  7. Relationship between the MDS-UPDRS and Quality of Life: A large multicenter study of 3206 patients.

    Science.gov (United States)

    Skorvanek, Matej; Martinez-Martin, Pablo; Kovacs, Norbert; Zezula, Ivan; Rodriguez-Violante, Mayela; Corvol, Jean-Christophe; Taba, Pille; Seppi, Klaus; Levin, Oleg; Schrag, Anette; Aviles-Olmos, Iciar; Alvarez-Sanchez, Mario; Arakaki, Tomoko; Aschermann, Zsuzsanna; Benchetrit, Eve; Benoit, Charline; Bergareche-Yarza, Alberto; Cervantes-Arriaga, Amin; Chade, Anabel; Cormier, Florence; Datieva, Veronika; Gallagher, David A; Garretto, Nelida; Gdovinova, Zuzana; Gershanik, Oscar; Grofik, Milan; Han, Vladimir; Kadastik-Eerme, Liis; Kurtis, Monica M; Mangone, Graziella; Martinez-Castrillo, Juan Carlos; Mendoza-Rodriguez, Amelia; Minar, Michal; Moore, Henry P; Muldmaa, Mari; Mueller, Christoph; Pinter, Bernadette; Poewe, Werner; Rallmann, Karin; Reiter, Eva; Rodriguez-Blazquez, Carmen; Singer, Carlos; Valkovic, Peter; Goetz, Christopher G; Stebbins, Glenn T

    2018-03-28

    The relationship between Health-Related Quality of Life (HRQoL) and MDS-UPDRS has not been fully studied so far. The aim of this study was to evaluate the relationship between all MDS-UPDRS components and HRQoL in a representative international cohort of PD patients. We collected demographic and disease-related data as well as MDS-UPDRS and PDQ8 scales. Data were analyzed using correlations between PDQ8 and all MDS-UPDRS items, subsequently two hierarchical multiple regressions were performed, first between the scores of the MDS-UPDRS Parts and PDQ8 and second between individual items from those Parts demonstrating significant relationship to PDQ8 scores in the first regression. LASSO regression analyses were performed to evaluate the relationship between PDQ8 and all individual MDS-UPDRS items. A total of 3206 PD patients were included in the study. In the first regression analysis, PDQ8 was significantly related to MDS-UPDRS parts I and II, but not to III and IV. In the second regression model, significant contributions to PDQ8 were found for Part I items Fatigue, Pain, Depressed mood, Apathy; and Part II items Dressing, Doing hobbies, Freezing, Speech and Tremor. In the LASSO analysis, six Part I, seven Part II, three Part III and one Part IV items contributed to PDQ8 scores. The five items most significantly related to the model were Depressed mood, Dressing, Apathy, Pain and Fatigue. This is so far the largest study related to HRQoL issues in PD. Restrictions in activities of daily living and non-motor symptoms significantly contribute to HRQoL in PD. Copyright © 2018. Published by Elsevier Ltd.

  8. Relationship between the MDS-UPDRS domains and the health-related quality of life of Parkinson's disease patients.

    Science.gov (United States)

    Martínez-Martín, P; Rodríguez-Blázquez, C; Forjaz, M J; Alvarez-Sánchez, M; Arakaki, T; Bergareche-Yarza, A; Chade, A; Garretto, N; Gershanik, O; Kurtis, M M; Martínez-Castrillo, J C; Mendoza-Rodríguez, A; Moore, H P; Rodríguez-Violante, M; Singer, C; Tilley, B C; Huang, J; Stebbins, G T; Goetz, C G

    2014-03-01

    The Movement Disorder Society sponsored version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is a comprehensive instrument for assessing Parkinson's disease (PD). The present study was aimed at determining the relationships between MDS-UPDRS components and health-related quality of life (HRQoL) evaluations in PD patients. An international, multicenter, cross-sectional study was carried out of 435 PD patients assessed with the MDS-UPDRS, Hoehn and Yahr (HY), Clinical Impression Severity for PD, EQ-5D and PD Questionnaire - eight items (PDQ-8). Spearman's rank correlation coefficients, exploratory factor analysis and multiple linear regression models (dependent variables EQ-5D and PDQ-8) were performed. The participants' age was 66.71 ± 10.32 years (51.5% men). PD duration was 8.52 ± 6.14, and median HY was 2 (range 1-5). The correlation between the EQ-5D index and the MDS-UPDRS ranged from -0.46 (Part IV) to -0.72 (Part II) and for the PDQ-8 index from 0.47 (Part III) to 0.74 (Part II). In multiple regression models with the MDS-UPDRS domains as independent variables, the main determinant for both the EQ-5D index and the PDQ-8 was Part II followed by Part I. After factorial grouping of the cardinal PD manifestations embedded in the MDS-UPDRS Parts III and IV for inclusion into multiple regression models, a factor formed by M-EDL, nM-EDL and fluctuations was the main determinant for both the EQ-5D and PDQ-8 indexes. The MDS-UPDRS component most tightly related with the HRQoL measures was a combination of motor and non-motor experiences of daily living. © 2014 The Author(s) European Journal of Neurology © 2014 EFNS.

  9. Comparison of clinical outcomes and prognostic utility of risk stratification tools in patients with therapy-related vs de novo myelodysplastic syndromes: a report on behalf of the MDS Clinical Research Consortium.

    Science.gov (United States)

    Zeidan, A M; Al Ali, N; Barnard, J; Padron, E; Lancet, J E; Sekeres, M A; Steensma, D P; DeZern, A; Roboz, G; Jabbour, E; Garcia-Manero, G; List, A; Komrokji, R

    2017-06-01

    While therapy-related (t)-myelodysplastic syndromes (MDS) have worse outcomes than de novo MDS (d-MDS), some t-MDS patients have an indolent course. Most MDS prognostic models excluded t-MDS patients during development. The performances of the International Prognostic Scoring System (IPSS), revised IPSS (IPSS-R), MD Anderson Global Prognostic System (MPSS), WHO Prognostic Scoring System (WPSS) and t-MDS Prognostic System (TPSS) were compared among patients with t-MDS. Akaike information criteria (AIC) assessed the relative goodness of fit of the models. We identified 370 t-MDS patients (19%) among 1950 MDS patients. Prior therapy included chemotherapy alone (48%), chemoradiation (31%), and radiation alone in 21%. Median survival for t-MDS patients was significantly shorter than for d-MDS (19 vs 46 months, PMDS (PMDS had a significantly higher hazard of death relative to d-MDS in every risk model, and had inferior survival compared to patients with d-MDS within all risk group categories. AIC Scores (lower is better) were 2316 (MPSS), 2343 (TPSS), 2343 (IPSS-R), 2361 (WPSS) and 2364 (IPSS). In conclusion, subsets of t-MDS patients with varying clinical outcomes can be identified using conventional risk stratification models. The MPSS, TPSS and IPSS-R provide the best predictive power.

  10. Overall survival in lower IPSS risk MDS by receipt of iron chelation therapy, adjusting for patient-related factors and measuring from time of first red blood cell transfusion dependence: an MDS-CAN analysis.

    Science.gov (United States)

    Leitch, Heather A; Parmar, Ambica; Wells, Richard A; Chodirker, Lisa; Zhu, Nancy; Nevill, Thomas J; Yee, Karen W L; Leber, Brian; Keating, Mary-Margaret; Sabloff, Mitchell; St Hilaire, Eve; Kumar, Rajat; Delage, Robert; Geddes, Michelle; Storring, John M; Kew, Andrea; Shamy, April; Elemary, Mohamed; Lenis, Martha; Mamedov, Alexandre; Ivo, Jessica; Francis, Janika; Zhang, Liying; Buckstein, Rena

    2017-10-01

    Analyses suggest iron overload in red blood cell (RBC) transfusion-dependent (TD) patients with myleodysplastic syndrome (MDS) portends inferior overall survival (OS) that is attenuated by iron chelation therapy (ICT) but may be biassed by unbalanced patient-related factors. The Canadian MDS Registry prospectively measures frailty, comorbidity and disability. We analysed OS by receipt of ICT, adjusting for these patient-related factors. TD International Prognostic Scoring System (IPSS) low and intermediate-1 risk MDS, at RBC TD, were included. Predictive factors for OS were determined. A matched pair analysis considering age, revised IPSS, TD severity, time from MDS diagnosis to TD, and receipt of disease-modifying agents was conducted. Of 239 patients, 83 received ICT; frailty, comorbidity and disability did not differ from non-ICT patients. Median OS from TD was superior in ICT patients (5·2 vs. 2·1 years; P MDS, adjusting for age, frailty, comorbidity, disability, revised IPSS, TD severity, time to TD and receiving disease-modifying agents. This provides additional evidence that ICT may confer clinical benefit. © 2017 John Wiley & Sons Ltd.

  11. The DVB Channel Coding Application Using the DSP Development Board MDS TM-13 IREF

    Directory of Open Access Journals (Sweden)

    M. Slanina

    2004-12-01

    Full Text Available The paper deals with the implementation of the channel codingaccording to DVB standard on DSP development board MDS TM-13 IREF andPC. The board is based on Philips Nexperia media processor andintegrates hardware video ADC and DAC. The program libraries featuresused for MPEG based video compression are outlined and then thealgorithms of channel decoding (FEC protection against errors arepresented including the flowchart diagrams. The paper presents thepartial hardware implementation of the simulation system that coversselected phenomena of DVB baseband processing and it is used for realtime interactive demonstration of error protection influence ontransmitted digital video in laboratory and education.

  12. Co-localization between the BOLD response and epileptiform discharges recorded by simultaneous intracranial EEG-fMRI at 3 T

    Directory of Open Access Journals (Sweden)

    Yahya Aghakhani

    2015-01-01

    Conclusions: iEEG-fMRI is a feasible and low-risk method for assessment of hemodynamic changes of very focal IEDs that may not be recorded by scalp EEG. A high concordance rate between the location of the BOLD response and IEDs was seen for mesial temporal (6/7 IEDs. Significant BOLD activation was also seen in areas distant from the active electrode and these sites exhibited maximal BOLD activation in the majority of cases. This implies that iEEG-fMRI may further describe the areas involved in the generation of IEDs beyond the vicinity of the electrode(s.

  13. Classification of Multiple Chinese Liquors by Means of a QCM-based E-Nose and MDS-SVM Classifier.

    Science.gov (United States)

    Li, Qiang; Gu, Yu; Jia, Jing

    2017-01-30

    Chinese liquors are internationally well-known fermentative alcoholic beverages. They have unique flavors attributable to the use of various bacteria and fungi, raw materials, and production processes. Developing a novel, rapid, and reliable method to identify multiple Chinese liquors is of positive significance. This paper presents a pattern recognition system for classifying ten brands of Chinese liquors based on multidimensional scaling (MDS) and support vector machine (SVM) algorithms in a quartz crystal microbalance (QCM)-based electronic nose (e-nose) we designed. We evaluated the comprehensive performance of the MDS-SVM classifier that predicted all ten brands of Chinese liquors individually. The prediction accuracy (98.3%) showed superior performance of the MDS-SVM classifier over the back-propagation artificial neural network (BP-ANN) classifier (93.3%) and moving average-linear discriminant analysis (MA-LDA) classifier (87.6%). The MDS-SVM classifier has reasonable reliability, good fitting and prediction (generalization) performance in classification of the Chinese liquors. Taking both application of the e-nose and validation of the MDS-SVM classifier into account, we have thus created a useful method for the classification of multiple Chinese liquors.

  14. Classification of Multiple Chinese Liquors by Means of a QCM-based E-Nose and MDS-SVM Classifier

    Directory of Open Access Journals (Sweden)

    Qiang Li

    2017-01-01

    Full Text Available Chinese liquors are internationally well-known fermentative alcoholic beverages. They have unique flavors attributable to the use of various bacteria and fungi, raw materials, and production processes. Developing a novel, rapid, and reliable method to identify multiple Chinese liquors is of positive significance. This paper presents a pattern recognition system for classifying ten brands of Chinese liquors based on multidimensional scaling (MDS and support vector machine (SVM algorithms in a quartz crystal microbalance (QCM-based electronic nose (e-nose we designed. We evaluated the comprehensive performance of the MDS-SVM classifier that predicted all ten brands of Chinese liquors individually. The prediction accuracy (98.3% showed superior performance of the MDS-SVM classifier over the back-propagation artificial neural network (BP-ANN classifier (93.3% and moving average-linear discriminant analysis (MA-LDA classifier (87.6%. The MDS-SVM classifier has reasonable reliability, good fitting and prediction (generalization performance in classification of the Chinese liquors. Taking both application of the e-nose and validation of the MDS-SVM classifier into account, we have thus created a useful method for the classification of multiple Chinese liquors.

  15. TP53 suppression promotes erythropoiesis in del(5q) MDS, suggesting a targeted therapeutic strategy in lenalidomide-resistant patients

    Science.gov (United States)

    Caceres, Gisela; McGraw, Kathy; Yip, Bon Ham; Pellagatti, Andrea; Johnson, Joseph; Zhang, Ling; Liu, Kenian; Zhang, Lan Min; Fulp, William J.; Lee, Ji-Hyun; Al Ali, Najla H.; Basiorka, Ashley; Smith, Larry J.; Daugherty, F. Joseph; Littleton, Neil; Wells, Richard A.; Sokol, Lubomir; Wei, Sheng; Komrokji, Rami S.; Boultwood, Jacqueline; List, Alan F.

    2013-01-01

    Stabilization of p53 in erythroid precursors in response to nucleosomal stress underlies the hypoplastic anemia in myelodysplastic syndromes (MDS) with chromosome 5q deletion [del(5q)]. We investigated whether cenersen, a clinically active 20-mer antisense oligonucleotide complementary to TP53 exon10, could suppress p53 expression and restore erythropoiesis in del(5q) MDS. Cenersen treatment of ribosomal protein S-14-deficient erythroblasts significantly reduced cellular p53 and p53-up-regulated modulator of apoptosis expression compared with controls, accompanied by a significant reduction in apoptosis and increased cell proliferation. In a two-stage erythroid differentiation assay, cenersen significantly suppressed nuclear p53 in bone marrow CD34+ cells isolated from patients with del(5q) MDS, whereas erythroid burst recovery increased proportionally to the magnitude of p53 suppression without evidence of del(5q) clonal suppression (r = −0.6; P = 0.005). To explore the effect of p53 suppression on erythropoiesis in vivo, dexamethasone, a glucocorticoid receptor-dependent p53 antagonist, was added to lenalidomide treatment in eight lower-risk, transfusion-dependent, del(5q) MDS patients with acquired drug resistance. Transfusion independence was restored in five patients accompanied by expansion of erythroid precursors and decreased cellular p53 expression. We conclude that targeted suppression of p53 could support effective erythropoiesis in lenalidomide-resistant del(5q) MDS. PMID:24043769

  16. Results of allogeneic stem cell transplantation in the Spanish MDS registry: prognostic factors for low risk patients.

    Science.gov (United States)

    Díez Campelo, M; Sánchez-Barba, M; de Soria, V Gómez-García; Martino, R; Sanz, G; Insunza, A; Bernal, T; Duarte, R; Amigo, M L; Xicoy, B; Tormo, M; Iniesta, F; Bailén, A; Benlloch, L; Córdoba, I; López-Villar, O; Del Cañizo, M C

    2014-10-01

    Although new agents have been approved for the treatment of MDS, the only curative approach is allogeneic hematopoietic stem cell transplantation (HSCT) and thus, in particular circumstances this procedure has been proposed as a treatment option for low risk patients. We have retrospectively analyzed the results of HSCT in 291 patients from the Spanish MDS registry with special attention to low risk MDS (LR-MDS) in order to define the variables that could impact their clinical evolution after transplantation. At 2 years OS was 51% and EFS was 50% (95% CI 0.7-4.5 years for OS and 95% CI 0.1-3.9 years for EFS). Among 43 LR-MDS, transplant-related mortality was 28%. At 3 years, OS was 67% (95% CI 264.7-8927.2 days for OS) and EFS was 64% (95% CI 0-9697.2 days for EFS). In the multivariate analysis only cytogenetics retained statistical significant effect on both OS (p=.047) and EFS (p=.046). Conditioning regimen could improve outcome among this subset of patients (OS 86% and RFS 100% for patients receiving RIC regimen). The present study confirms that specific disease characteristic as well as transplant characteristics have a significant impact on transplant outcome. Regarding low risk patients a non-myeloablative conditioning would be preferable especially in cases without high-risk cytogenetics. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Tissue-Specific Upregulation of MDS/EVI Gene Transcripts in the Intestine by Thyroid Hormone during Xenopus Metamorphosis

    Science.gov (United States)

    Hasebe, Takashi; Fu, Liezhen; Heimeier, Rachel A.; Das, Biswajit; Ishizuya-Oka, Atsuko; Shi, Yun-Bo

    2013-01-01

    Background Intestinal remodeling during amphibian metamorphosis resembles the maturation of the adult intestine during mammalian postembryonic development when the adult epithelial self-renewing system is established under the influence of high concentrations of plasma thyroid hormone (T3). This process involves de novo formation and subsequent proliferation and differentiation of the adult stem cells. Methodology/Principal Findings The T3-dependence of the formation of adult intestinal stem cell during Xenopus laevis metamorphosis offers a unique opportunity to identify genes likely important for adult organ-specific stem cell development. We have cloned and characterized the ectopic viral integration site 1 (EVI) and its variant myelodysplastic syndrome 1 (MDS)/EVI generated via transcription from the upstream MDS promoter and alternative splicing. EVI and MDS/EVI have been implicated in a number of cancers including breast, leukemia, ovarian, and intestinal cancers. We show that EVI and MDS/EVI transcripts are upregulated by T3 in the epithelium but not the rest of the intestine in Xenopus laevis when adult stem cells are forming in the epithelium. Conclusions/Significance Our results suggest that EVI and MDS/EVI are likely involved in the development and/or proliferation of newly forming adult intestinal epithelial cells. PMID:23383234

  18. Discharge Dialogue

    DEFF Research Database (Denmark)

    Horsbøl, Anders

    2012-01-01

    For several years, efforts have been made to strengthen collaboration between health professionals with different specializations and to improve patient transition from hospital to home (care). In the Danish health care system, these efforts have concentrated on cancer and heart diseases, whereas...... coordinator, employed at the hospital, is supposed to anticipate discharge and serve as mediator between the hospital and the municipal home care system. Drawing on methods from discourse and interaction analysis, the paper studies the practice of the discharge coordinator in two encounters between patients...... how the home context provides different resources for identification of patient needs and mutual decision making....

  19. Wormhole Detection Based on Ordinal MDS Using RTT in Wireless Sensor Network

    Directory of Open Access Journals (Sweden)

    Saswati Mukherjee

    2016-01-01

    Full Text Available In wireless communication, wormhole attack is a crucial threat that deteriorates the normal functionality of the network. Invasion of wormholes destroys the network topology completely. However, most of the existing solutions require special hardware or synchronized clock or long processing time to defend against long path wormhole attacks. In this work, we propose a wormhole detection method using range-based topology comparison that exploits the local neighbourhood subgraph. The Round Trip Time (RTT for each node pair is gathered to generate neighbour information. Then, the network is reconstructed by ordinal Multidimensional Scaling (MDS followed by a suspicion phase that enlists the suspected wormholes based on the spatial reconstruction. Iterative computation of MDS helps to visualize the topology changes and can localize the potential wormholes. Finally, a verification phase is used to remove falsely accused nodes and identify real adversaries. The novelty of our algorithm is that it can detect both short path and long path wormhole links. Extensive simulations are executed to demonstrate the efficacy of our approach compared to existing ones.

  20. Role of casein kinase 1A1 in the biology and targeted therapy of del(5q) MDS

    Science.gov (United States)

    Schneider, Rebekka K.; Ademà, Vera; Heckl, Dirk; Järås, Marcus; Mallo, Mar; Lord, Allegra M.; Chu, Lisa P.; McConkey, Marie E.; Kramann, Rafael; Mullally, Ann; Bejar, Rafael; Solé, Francesc; Ebert, Benjamin L.

    2014-01-01

    Summary The Casein kinase 1A1 gene (CSNK1A1) is a putative tumor suppressor gene located in the common deleted region for del(5q) myelodysplastic syndrome (MDS). We generated a murine model with conditional inactivation of Csnk1a1 and found that Csnk1a1 haploinsufficiency induces hematopoietic stem cell expansion and a competitive repopulation advantage whereas homozygous deletion induces hematopoietic stem cell failure. Based on this finding, we found that heterozygous inactivation of Csnk1a1 sensitizes cells to a CSNK1 inhibitor relative to cells with two intact alleles. In addition, we identified recurrent somatic mutations in CSNK1A1 on the non-deleted allele of patients with del(5q) MDS. These studies demonstrate that CSNK1A1 plays a central role in the biology of del(5q) MDS and is a promising therapeutic target. PMID:25242043

  1. Expanded and independent validation of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS).

    Science.gov (United States)

    Martinez-Martin, Pablo; Rodriguez-Blazquez, Carmen; Alvarez-Sanchez, Mario; Arakaki, Tomoko; Bergareche-Yarza, Alberto; Chade, Anabel; Garretto, Nelida; Gershanik, Oscar; Kurtis, Monica M; Martinez-Castrillo, Juan Carlos; Mendoza-Rodriguez, Amelia; Moore, Henry P; Rodriguez-Violante, Mayela; Singer, Carlos; Tilley, Barbara C; Huang, Jing; Stebbins, Glenn T; Goetz, Christopher G

    2013-01-01

    The Movement Disorder Society-UPDRS (MDS-UPDRS) was published in 2008, showing satisfactory clinimetric results and has been proposed as the official benchmark scale for Parkinson's disease. The present study, based on the official MDS-UPDRS Spanish version, performed the first independent testing of the scale and adds information on its clinimetric properties. The cross-culturally adapted MDS-UPDRS Spanish version showed a comparative fit index ≥ 0.90 for each part (I-IV) relative to the English-language version and was accepted as the Official MDS-UPDRS Spanish version. Data from this scale, applied with other assessments to Spanish-speaking Parkinson's disease patients in five countries, were analyzed for an independent and complementary clinimetric evaluation. In total, 435 patients were included. Missing data were negligible and moderate floor effect (30 %) was found for Part IV. Cronbach's α index ranged between 0.79 and 0.93 and only five items did not reach the 0.30 threshold value of item-total correlation. Test-retest reliability was adequate with only two sub-scores of the item 3.17, Rest tremor amplitude, reaching κ values lower than 0.60. The intraclass correlation coefficient was higher than 0.85 for the total score of each part. Correlation of the MDS-UPDRS parts with other measures for related constructs was high (≥ 0.60) and the standard error of measurement lower than one-third baseline standard deviation for all subscales. Results confirm those of the original study and add information on scale reliability, construct validity, and precision. The MDS-UPDRS Spanish version shows satisfactory clinimetric characteristics.

  2. Therapy Related AML/MDS Following Treatment for Childhood Cancer: Experience from a Tertiary Care Centre in North India.

    Science.gov (United States)

    Vyas, Chintan; Jain, Sandeep; Kapoor, Gauri

    2018-01-01

    Therapy-related acute myeloid leukemia/myelodysplastic syndrome (t-AML/MDS) is a devastating late effect of cancer treatment. There is limited data on incidence of t-AML/MDS from India. We retrospectively studied pediatric t AML/MDS at our institute between January 1996 and December 2015. Among 1285 children, 8 patients developed t-AML with a median age of 15.5 years. Overall incidence of t-AML/MDS was 0.62% [0.99% (4/402) in solid tumours and 0.45% (4/883) in leukemia/lymphoma, P  = 0.26] with 6390 patient years of follow up. Primary malignancy included sarcoma [bone (2), soft tissue (2)], B-non-Hodgkin lymphoma (2) and acute lymphoblastic leukemia (2). The median cumulative equivalent doses of cyclophosphamide, doxorubicin and etoposide were 6.8, 270 and 2.5 gm/m 2 respectively. Two patients received radiotherapy [rhabdomyosarcoma (50 Gy), synovial sarcoma (45 Gy)]. The median latency period to develop t-AML/MDS was 24 months (range 16.5-62 months). Most common FAB morphology was M4/M5 (7/8) and cytogenetic abnormality was MLL rearrangement (4/8). Five patients opted for treatment, 4 achieved remission out of which 2 patients are alive and disease free. Short latency periods, absence of pre-leukemic phase and 11q23 translocations were characteristic in the patients with t-AML/MDS. In view of poor outcome with conventional therapy, novel strategies and prevention need to be considered.

  3. Eighty years of food-web response to interannual variation in discharge recorded in river diatom frustules from an ocean sediment core.

    Science.gov (United States)

    Sculley, John B; Lowe, Rex L; Nittrouer, Charles A; Drexler, Tina M; Power, Mary E

    2017-09-19

    Little is known about the importance of food-web processes as controls of river primary production due to the paucity of both long-term studies and of depositional environments which would allow retrospective fossil analysis. To investigate how freshwater algal production in the Eel River, northern California, varied over eight decades, we quantified siliceous shells (frustules) of freshwater diatoms from a well-dated undisturbed sediment core in a nearshore marine environment. Abundances of freshwater diatom frustules exported to Eel Canyon sediment from 1988 to 2001 were positively correlated with annual biomass of Cladophora surveyed over these years in upper portions of the Eel basin. Over 28 years of contemporary field research, peak algal biomass was generally higher in summers following bankfull, bed-scouring winter floods. Field surveys and experiments suggested that bed-mobilizing floods scour away overwintering grazers, releasing algae from spring and early summer grazing. During wet years, growth conditions for algae could also be enhanced by increased nutrient loading from the watershed, or by sustained summer base flows. Total annual rainfall and frustule densities in laminae over a longer 83-year record were weakly and negatively correlated, however, suggesting that positive effects of floods on annual algal production were primarily mediated by "top-down" (consumer release) rather than "bottom-up" (growth promoting) controls.

  4. Eighty years of food-web response to interannual variation in discharge recorded in river diatom frustules from an ocean sediment core

    Science.gov (United States)

    Sculley, John B.; Lowe, Rex L.; Nittrouer, Charles A.; Drexler, Tina M.; Power, Mary E.

    2017-01-01

    Little is known about the importance of food-web processes as controls of river primary production due to the paucity of both long-term studies and of depositional environments which would allow retrospective fossil analysis. To investigate how freshwater algal production in the Eel River, northern California, varied over eight decades, we quantified siliceous shells (frustules) of freshwater diatoms from a well-dated undisturbed sediment core in a nearshore marine environment. Abundances of freshwater diatom frustules exported to Eel Canyon sediment from 1988 to 2001 were positively correlated with annual biomass of Cladophora surveyed over these years in upper portions of the Eel basin. Over 28 years of contemporary field research, peak algal biomass was generally higher in summers following bankfull, bed-scouring winter floods. Field surveys and experiments suggested that bed-mobilizing floods scour away overwintering grazers, releasing algae from spring and early summer grazing. During wet years, growth conditions for algae could also be enhanced by increased nutrient loading from the watershed, or by sustained summer base flows. Total annual rainfall and frustule densities in laminae over a longer 83-year record were weakly and negatively correlated, however, suggesting that positive effects of floods on annual algal production were primarily mediated by “top-down” (consumer release) rather than “bottom-up” (growth promoting) controls. PMID:28874576

  5. Monitoring of lightning discharge

    International Nuclear Information System (INIS)

    Grigor'ev, V.A.

    2001-01-01

    The paper presents a brief description of a lightning discharge recording system developed at the NPO 'Monitoring Techniques' under the direction of V.M. Moskolenko (Moscow). The system provides information about dangerous environmental occurrences such as tornados and hurricanes, making the forecast of extreme situations possible, especially in the areas of dangerous industries and objects. The created automatic system can be useful in solving the tasks relating to nuclear test monitoring. (author)

  6. Birth Settings and the Validation of Neonatal Seizures Recorded in Birth Certificates Compared to Medicaid Claims and Hospital Discharge Abstracts Among Live Births in South Carolina, 1996-2013.

    Science.gov (United States)

    Li, Qing; Jenkins, Dorothea D; Kinsman, Stephen L

    2017-05-01

    Objective Neonatal seizures in the first 28 days of life often reflect underlying brain injury or abnormalities, and measure the quality of perinatal care in out-of-hospital births. Using the 2003 revision of birth certificates only, three studies reported more neonatal seizures recorded among home births ​or planned out-of-hospital births compared to hospital births. However, the validity of recording neonatal seizures or serious neurologic dysfunction across birth settings in birth certificates has not been evaluated. We aimed to validate seizure recording in birth certificates across birth settings using multiple datasets. Methods We examined checkbox items "seizures" and "seizure or serious neurologic dysfunction" in the 1989 and 2003 revisions of birth certificates in South Carolina from 1996 to 2013. Gold standards were ICD-9-CM codes 779.0, 345.X, and 780.3 in either hospital discharge abstracts or Medicaid encounters jointly. Results Sensitivity, positive predictive value, false positive rate, and the kappa statistic of neonatal seizures recording were 7%, 66%, 34%, and 0.12 for the 2003 revision of birth certificates in 547,177 hospital births from 2004 to 2013 and 5%, 33%, 67%, and 0.09 for the 1998 revision in 396,776 hospital births from 1996 to 2003, and 0, 0, 100%, -0.002 among 660 intended home births from 2004 to 2013 and 920 home births from 1996 to 2003, respectively. Conclusions for Practice Despite slight improvement across revisions, South Carolina birth certificates under-reported or falsely reported seizures among hospital births and especially home births. Birth certificates alone should not be used to measure neonatal seizures or serious neurologic dysfunction.

  7. Angioplasty and stent - heart - discharge

    Science.gov (United States)

    Drug-eluting stents - discharge; PCI - discharge; Percutaneous coronary intervention - discharge; Balloon angioplasty - discharge; Coronary angioplasty - discharge; Coronary artery angioplasty - discharge; Cardiac ...

  8. Radiological discharges

    International Nuclear Information System (INIS)

    Woodliffe, J.

    1990-01-01

    Current practice of North Sea States on the discharge and disposal of liquid radioactive wastes to the North Sea are based on the declaration issued at the Second International Conference on the Protection of the North Sea, known as the London Declaration. This has three main points the first of which emphasises the application of the Best Available Technology to protect the North Sea, the second provides a framework on which future controls on radioactive discharges should be based. The third identifies two parts of the framework; to take into account the recommendations of international organizations and that any repositories of radioactive waste which are built should not pollute the North Sea. This chapter looks at how the concensus based on the London Declaration is working, gauges the progress made in the implementation of the policy goal, identifies existing and future areas for concern and proposes ways of strengthening the control of radioactive discharges. The emphasis is on the United Kingdom practice and regulations for liquid wastes, most of which comes from the Sellafield Reprocessing Plant. (author)

  9. Spliceosomal gene aberrations are rare, coexist with oncogenic mutations, and are unlikely to exert a driver effect in childhood MDS and JMML

    NARCIS (Netherlands)

    S. Hirabayashi (Shinsuke); C. Flotho (Christian); J. Moetter (Jessica); M. Heuser (Michael); H. Hasle (Henrik); B. Gruhn (Bernd); T. Klingebiel (Thomas); F. Thol (Felicitas); B. Schlegelberger (Brigitte); I. Baumann (Irith); B. Strahm (Brigitte); J. Stary (Jan); F. Locatelli (Franco); M. Zecca (Marco); E. Bergstraesser (Eva); M.N. Dworzak (Michael); M.M. van den Heuvel-Eibrink (Marry); B. de Moerloose (Barbara); S. Ogawa (Susumu); C.M. Niemeyer (Charlotte); M. Wlodarski (Marcin)

    2012-01-01

    textabstractSomatic mutations of the spliceosomal machinery occur frequently in adult patients with myelodysplastic syndrome (MDS). We resequenced SF3B1, U2AF35, and SRSF2 in 371 children with MDS or juvenile myelomonocytic leukemia. We found missense mutations in 2 juvenile myelomonocytic leukemia

  10. Aplastic Anemia and MDS International Foundation (AAMDSIF): Bone marrow failure disease scientific symposium 2016.

    Science.gov (United States)

    Zeidan, Amer M; Battiwalla, Minoo; Berlyne, Deborah; Winkler, Thomas

    2017-02-01

    Patients with acquired and inherited bone marrow failure syndromes (BMFS) have ineffective hematopoiesis due to impairments of the hematopoietic stem cell compartment. Common manifestations of BMFS include varying degrees of peripheral blood cytopenias and, sometimes, progression to acute myelogenous leukemia. Research efforts have been made all over the world to improve understanding of the pathogenesis of these diseases and their clinical implications. The Aplastic Anemia and MDS International Foundation (AAMDSIF) is an independent nonprofit organization whose mission is to help patients and family members cope with BMFS. Here, we summarize recent scientific discoveries in several BMFS that were presented at the fifth International Bone Marrow Failure Disease Scientific Symposium 2016 that AAMDSIF sponsored on March 17-18, 2016, in Rockville, Maryland. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Additive Construction with Mobile Emplacement (ACME) / Automated Construction of Expeditionary Structures (ACES) Materials Delivery System (MDS)

    Science.gov (United States)

    Mueller, R. P.; Townsend, I. I.; Tamasy, G. J.; Evers, C. J.; Sibille, L. J.; Edmunson, J. E.; Fiske, M. R.; Fikes, J. C.; Case, M.

    2018-01-01

    The purpose of the Automated Construction of Expeditionary Structures, Phase 3 (ACES 3) project is to incorporate the Liquid Goods Delivery System (LGDS) into the Dry Goods Delivery System (DGDS) structure to create an integrated and automated Materials Delivery System (MDS) for 3D printing structures with ordinary Portland cement (OPC) concrete. ACES 3 is a prototype for 3-D printing barracks for soldiers in forward bases, here on Earth. The LGDS supports ACES 3 by storing liquid materials, mixing recipe batches of liquid materials, and working with the Dry Goods Feed System (DGFS) previously developed for ACES 2, combining the materials that are eventually extruded out of the print nozzle. Automated Construction of Expeditionary Structures, Phase 3 (ACES 3) is a project led by the US Army Corps of Engineers (USACE) and supported by NASA. The equivalent 3D printing system for construction in space is designated Additive Construction with Mobile Emplacement (ACME) by NASA.

  12. Isotopes and innovation: MDS Nordion's first fifty years, 1946-1996

    International Nuclear Information System (INIS)

    Litt, P.

    2000-01-01

    Few people realize that Canada leads in the world in the production of radio isotopes, the raw material of nuclear medicine and high-tech scanners, and in their use in medicine and industry. In Isotopes and Innovation the author gives an in-depth look at MDS Nordion, a company that started as the radium sales department of Eldorado Mining and Refining, the Canadian uranium producer that was a key strategic resource for the Allies during the race to build the nuclear bomb, and went on to become the world?s leading producer of radioisotopes. When radium began to be used as a cancer treatment, Eldorado quickly became familiar with the medical marketplace and adept at developing products that could solve clinical problems and, more important, save lives. When Canadian nuclear reactors at Chalk River began producing radioisotopes that outperformed radium, Eldorado's radium sales department was transferred to a new crown corporation, Atomic Energy of Canada Limited, created to manage Canada's nuclear research establishment. The new company developed many useful applications for radioisotopes, including cobalt-60 cancer therapy machines and industrial sterilization plants. Bought by Medical Data Services Inc. in the early 1990s, MDS Nordion was a runaway success, creator and sole proprietor of several market-leading products. Isotopes and Innovation describes how a company capitalized on the byproducts of Canada's unique nuclear research program to attain a commanding international position in extremely specialized and demanding high-tech markets, a saga in which innovative research and enterprising global marketing have brought commercial success and saved countless lives around the world

  13. Isotopes and innovation: MDS Nordion's first fifty years, 1946-1996

    Energy Technology Data Exchange (ETDEWEB)

    Litt, P

    2000-07-01

    Few people realize that Canada leads in the world in the production of radio isotopes, the raw material of nuclear medicine and high-tech scanners, and in their use in medicine and industry. In Isotopes and Innovation the author gives an in-depth look at MDS Nordion, a company that started as the radium sales department of Eldorado Mining and Refining, the Canadian uranium producer that was a key strategic resource for the Allies during the race to build the nuclear bomb, and went on to become the world?s leading producer of radioisotopes. When radium began to be used as a cancer treatment, Eldorado quickly became familiar with the medical marketplace and adept at developing products that could solve clinical problems and, more important, save lives. When Canadian nuclear reactors at Chalk River began producing radioisotopes that outperformed radium, Eldorado's radium sales department was transferred to a new crown corporation, Atomic Energy of Canada Limited, created to manage Canada's nuclear research establishment. The new company developed many useful applications for radioisotopes, including cobalt-60 cancer therapy machines and industrial sterilization plants. Bought by Medical Data Services Inc. in the early 1990s, MDS Nordion was a runaway success, creator and sole proprietor of several market-leading products. Isotopes and Innovation describes how a company capitalized on the byproducts of Canada's unique nuclear research program to attain a commanding international position in extremely specialized and demanding high-tech markets, a saga in which innovative research and enterprising global marketing have brought commercial success and saved countless lives around the world.

  14. Impact Of Mutation-derived Antigens In Immune Recognition Of Hematological Malignancies, Specifically Myeloid Dysplastic Syndromes (MDS)

    DEFF Research Database (Denmark)

    Saini, Sunil Kumar; Dorfmüller, S.; Bjerregaard, Anne-Mette

    2016-01-01

    Mutation-derived neoepitopes have been suggested as a major component for immune recognition of solid tumors with a high mutational load, e.g. Melanoma and Non-Small-Cell Lung Cancer (NSCLC). Myelodysplastic syndromes (MDS) are a heterogeneous group of myeloid neoplasms characterized by increasing...

  15. Wheat Mds-1 encodes a heat-shock protein and governs susceptibility towards the Hessian fly gall midge

    Science.gov (United States)

    Plant pests including insects must manipulate plants in order to utilize the nutrition and environment of the host. Here, we show that the heat-shock protein gene Mayetiola destructor susceptibility gene-1 (Mds-1) is a major susceptibility gene in wheat that allows the gall midge M. destructor, com...

  16. Allogeneic hematopoietic stem cell transplant in adult patients with myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) overlap syndromes.

    Science.gov (United States)

    Sharma, Prashant; Shinde, Shivani S; Damlaj, Moussab; Hefazi Rorghabeh, Mehrdad; Hashmi, Shahrukh K; Litzow, Mark R; Hogan, William J; Gangat, Naseema; Elliott, Michelle A; Al-Kali, Aref; Tefferi, Ayalew; Patnaik, Mrinal M

    2017-04-01

    MDS/MPN (myelodysplastic syndrome/myeloproliferative neoplasm) overlap syndromes are myeloid malignancies for which allogeneic hematopoietic stem cell transplant (allo-HSCT) is potentially curative. We describe transplant outcomes of 43 patients - 35 with chronic myelomonocytic leukemia, CMML (of which 17 had blast transformation, BT) and eight with MDS/MPN-unclassifiable (MDS/MPN,U). At median follow-up of 21 months, overall survival (OS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) were 55%, 29%, and 25% respectively in CMML without BT and 47%, 40%, and 34% respectively in CMML with BT. Higher HSCT-comorbidity index (HSCT-CI >3 versus ≤3; p = 0.015) and splenomegaly (p = 0.006) predicted worse OS in CMML without BT. In CMML with BT, engraftment failure (p = 0.006) and higher HSCT-CI (p = 0.03) were associated with inferior OS, while HSCT within 1-year of diagnosis was associated with improved OS (p = 0.045). In MDS/MPN,U, at median follow-up of 15 months, OS, CIR, and NRM were 62%, 30%, and 14%, respectively.

  17. Defining AML and MDS second cancer risk dynamics after diagnoses of first cancers treated or not with radiation

    NARCIS (Netherlands)

    Radivoyevitch, T.; Sachs, R. K.; Gale, R. P.; Molenaar, R. J.; Brenner, D. J.; Hill, B. T.; Kalaycio, M. E.; Carraway, H. E.; Mukherjee, S.; Sekeres, M. A.; Maciejewski, J. P.

    2016-01-01

    Risks of acute myeloid leukemia (AML) and/or myelodysplastic syndromes (MDS) are known to increase after cancer treatments. Their rise-and-fall dynamics and their associations with radiation have, however, not been fully characterized. To improve risk definition we developed SEERaBomb R software for

  18. Hysterectomy - vaginal - discharge

    Science.gov (United States)

    Vaginal hysterectomy - discharge; Laparoscopically assisted vaginal hysterectomy - discharge; LAVH - discharge ... you were in the hospital, you had a vaginal hysterectomy. Your surgeon made a cut in your ...

  19. Cost-effectiveness of azacitidine compared with low-doses of chemotherapy (LDC in myelodysplastic syndrome (MDS

    Directory of Open Access Journals (Sweden)

    Myrna Candelaria-Hernández

    2017-06-01

    Full Text Available ABSTRACTIntroductionMyelodysplastic syndrome (MDS comprises a group of clonal hematological disorders, characterized by ineffective hematopoiesis and progressive bone marrow failure. It increases the risk of transformation to acute myeloid leukemia (AML. Therapeutic benefit should include overall survival increase (OS, hematological improvement, transfusion dependence and time to progression to AML decrease.ObjectiveAssess, from a Mexican health-care perspective, the cost-effectiveness of azacitidine compared with low-doses of chemotherapy (LDC plus best supportive care (BSC for the treatment of adult patients with intermediate-2 and high-risk MDS, who are not eligible for hematopoietic stem-cell transplantation. We developed a cost-effectiveness survival analysis model of three stages: MDS, AML, and death. OS and costs are extrapolated beyond three-year time horizon. Discount rate of 5% was applied. To estimate the model cycle probability transition to mortality state, survival curves were constructed for each treatment arm using individual patient-level data from Study AZA-001. Unitary costs are from public price list, and profiles for the management of MDS and AML were collected separately using a structured questionnaire. Probabilistic sensitivity analyses (PSA were conducted by simultaneously sampling from estimated probability distributions of model parameters.ResultsOverall survival was projected to increase by 72.26 weeks with azacitidine. Incremental expected total costs for azacitidine compared to LDC was MXN$68,045. However, the cost of the drug therapy was lower with azacitidine. The incremental cost-effectiveness ratio (ICER for azacitidine compared to LDC was MXN$48,932 per life-year gained (LYG. PSA showed that azacitidine was a highly cost-effective option in 96.49% of the simulated cases in MXN$180,000/LYG willingness-to-pay.ConclusionsCompared with LDC, azacitidine represents a cost-effective treatment alternative in patients

  20. Compact Intracloud Discharges

    Energy Technology Data Exchange (ETDEWEB)

    Smith, David A. [Univ. of Colorado, Boulder, CO (United States)

    1998-11-01

    In November of 1993, mysterious signals recorded by a satellite-borne broadband VHF radio science experiment called Blackboard led to a completely unexpected discovery. Prior to launch of the ALEXIS satellite, it was thought that its secondary payload, Blackboard, would most often detect the radio emissions from lightning when its receiver was not overwhelmed by noise from narrowband communication carriers. Instead, the vast majority of events that triggered the instrument were isolated pairs of pulses that were one hundred times more energetic than normal thunderstorm electrical emissions. The events, which came to be known as TIPPs (for transionospheric pulse pairs), presented a true mystery to the geophysics community. At the time, it was not even known whether the events had natural or anthropogenic origins. After two and one half years of research into the unique signals, two ground-based receiver arrays in New Mexico first began to detect and record thunderstorm radio emissions that were consistent with the Blackboard observations. On two occasions, the ground-based systems and Blackboard even recorded emissions that were produced by the same exact events. From the ground based observations, it has been determined that TIPP events areproduced by brief, singular, isolated, intracloud electrical discharges that occur in intense regions of thunderstorms. These discharges have been dubbed CIDS, an acronym for compact intracloud discharges. During the summer of 1996, ground-based receiver arrays were used to record the electric field change signals and broadband HF emissions from hundreds of CIDS. Event timing that was accurate to within a few microseconds made possible the determination of source locations using methods of differential time of arrival. Ionospheric reflections of signals were recorded in addition to groundwave/line-of-sight signals and were used to determine accurate altitudes for the discharges. Twenty-four CIDS were recorded from three

  1. Lung surgery - discharge

    Science.gov (United States)

    ... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

  2. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  3. Health-related quality of life in lower-risk MDS patients compared with age- and sex-matched reference populations: a European LeukemiaNet study.

    Science.gov (United States)

    Stauder, Reinhard; Yu, Ge; Koinig, Karin A; Bagguley, Tim; Fenaux, Pierre; Symeonidis, Argiris; Sanz, Guillermo; Cermak, Jaroslav; Mittelman, Moshe; Hellström-Lindberg, Eva; Langemeijer, Saskia; Holm, Mette Skov; Mądry, Krzysztof; Malcovati, Luca; Tatic, Aurelia; Germing, Ulrich; Savic, Aleksandar; van Marrewijk, Corine; Guerci-Bresler, Agnès; Luño, Elisa; Droste, Jackie; Efficace, Fabio; Smith, Alex; Bowen, David; de Witte, Theo

    2018-03-06

    In myelodysplastic syndromes (MDS), health-related quality of life (HRQoL) represents a relevant patient-reported outcome, which is essential in individualized therapy planning. Prospective data on HRQoL in lower-risk MDS remain rare. We assessed HRQOL by EQ-5D questionnaire at initial diagnosis in 1690 consecutive IPSS-Low/Int-1 MDS patients from the European LeukemiaNet Registry. Impairments were compared with age- and sex-matched EuroQol Group norms. A significant proportion of MDS patients reported moderate/severe problems in the dimensions pain/discomfort (49.5%), mobility (41.0%), anxiety/depression (37.9%), and usual activities (36.1%). Limitations in mobility, self-care, usual activities, pain/discomfort, and EQ-VAS were significantly more frequent in the old, in females, and in those with high co-morbidity burden, low haemoglobin levels, or red blood cells transfusion need (p MDS patients (p MDS-related restrictions in the dimension mobility were most prominent in males, and in older people (p MDS experience a pronounced reduction in HRQoL and a clustering of restrictions in distinct dimensions of HRQoL as compared with reference populations.

  4. [mRNA expression of notch ligand-delta-like-1 and jagged-1 in mesenchymal stem cells of MDS patients].

    Science.gov (United States)

    Fei, Cheng-Ming; Gu, Shu-Cheng; Zhao, You-Shan; Guo, Juan; Li, Xiao; Chang, Chun-Kang

    2014-12-01

    This study was aimed to investigated the mRNA expression levels of Notch ligands- Delta-like-1 and Jagged-1 in bone marrow mesenchymal stem cells of patients with myelodysplastic syndrome (MDS), and to explore their relation with onset of MDS. Bone marrow mesenchymal stem cells of 38 patients with MDS and 16 normal subjects as control were collected to detect mRNA expression of Delta-like-1 and Jagged-1 by using real-time quantitative polymerase chain reaction. The results showed that the expression levels of Delta-like-1 and Jagged-1 in mesenchymal stem cells of MDS patients were significantly higher than that in normal controls (P MDS patients (r = 0.502, P MDS patients with abnormal karyotypes were significantly higher than those in MDS patients with normal karyotypes (P 0.05). It is concluded that the changes of Delta-like-1 and Jagged-1 expression level in MSC may play a role in the pathogenesis of myelodysplastic syndrome.

  5. Survey of expert opinions and related recommendations regarding bridging therapy using hypomethylating agents followed by allogeneic transplantation for high-risk MDS.

    Science.gov (United States)

    Sohn, Sang Kyun; Moon, Joon Ho

    2015-08-01

    According to current guidelines on therapeutic strategies for myelodysplastic syndrome (MDS), cytoreductive therapies before allogeneic stem cell transplantation (SCT) are not widely recommended for patients with high-risk MDS or refractory anemia with excess blasts (RAEB) who are eligible for allogeneic SCT because of controversial evidence on the role of such therapies. Yet, while treatment with hypomethylating agents (HMAs) has a critical limitation in eradicating MDS clones, the use of HMA treatment as a bridge to allogeneic SCT has become a focus with the hope of improving the SCT outcome based on the chance of achieving complete remission or reducing the blast percentage safely and effectively before allogeneic SCT. However, a consensus needs to be established on the use of HMAs as a bridging therapy for high-risk MDS or RAEB. Thus, the Korean AML/MDS working party group surveyed 34 Korean MDS experts on their bridging therapies for high-risk MDS. Accordingly, this paper presents the survey questionnaire and resulting data, along with a summary of the consensus and related recommendations regarding strategies using HMA treatment and allogeneic SCT based on reported studies and the current survey results. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. A review of therapy-related myelodysplastic syndromes and acute myeloid leukaemia (t-MDS/AML) in Irish patients: a single centre experience.

    Science.gov (United States)

    Maung, Su W; Burke, Cathie; Hayde, Jennifer; Walshe, Janice; McDermott, Ray; Desmond, Ronan; McHugh, Johnny; Enright, Helen

    2017-07-01

    To demonstrate the incidence, characteristics, treatment and outcomes of patients with therapy-related myelodysplastic syndromes and therapy-related acute myeloid leukaemia (t-MDS/AML) in a tertiary referral centre. Patients meeting the diagnostic criteria for t-MDS/AML from 2003 to 2014 were reviewed to analyse their diagnostic features, details of antecedent disorder and treatment, approach to management and survival. 39 patients who developed t-MDS/AML were identified with incidence of 8.7%. Median age and gender distribution were similar to de novo MDS but t-MDS/AML patients had greater degree of cytopenia and adverse karyotypes. Time to development of t-MDS/AML was shortest for patients with antecedent haematological malignancy compared to solid tumours and autoimmune disorders (46, 85 and 109 months). Patients with prior acute leukaemia had the shortest latency and poor overall survival. Treatment options included best supportive care (56%), Azacitidine (31%) or intensive chemotherapy/allogeneic transplant (13%). Median OS of all patients was 14 months. Survival declined markedly after two years and 5-year OS was 13.8%. Longer survival was associated with blast count MDS/AML patients showed unique characteristics which influenced their treatment and outcomes. IPSS-R may be useful in risk-adapted treatment approaches and can predict outcomes. Survival remains poor but improved outcomes were seen with allogeneic transplantation. Azacitidine may be effective in patients unfit for intensive therapies.

  7. Progression of MDS-UPDRS Scores Over Five Years in De Novo Parkinson Disease from the Parkinson's Progression Markers Initiative Cohort.

    Science.gov (United States)

    Holden, Samantha K; Finseth, Taylor; Sillau, Stefan H; Berman, Brian D

    2018-01-01

    The Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UDPRS) is a commonly used tool to measure Parkinson disease (PD) progression. Longitudinal changes in MDS-UPDRS scores in de novo PD have not been established. Determine progression rates of MDS-UPDRS scores in de novo PD. 362 participants from the Parkinson's Progression Markers Initiative, a multicenter longitudinal cohort study of de novo PD, were included. Longitudinal progression of MDS-UPDRS total and subscale scores were modeled using mixed model regression. MDS-UPDRS scores increased in a linear fashion over five years in de novo PD. MDS-UPDRS total score increased an estimated 4.0 points/year, Part I 0.25 points/year, Part II 1.0 points/year, and Part III 2.4 points/year. The expected average progression of MDS-UPDRS scores in de novo PD from this study can assist in clinical monitoring and provide comparative data for detection of disease modification in treatment trials.

  8. Comprehensive mapping of the effects of azacitidine on DNA methylation, repressive/permissive histone marks and gene expression in primary cells from patients with MDS and MDS-related disease.

    Science.gov (United States)

    Tobiasson, Magnus; Abdulkadir, Hani; Lennartsson, Andreas; Katayama, Shintaro; Marabita, Francesco; De Paepe, Ayla; Karimi, Mohsen; Krjutskov, Kaarel; Einarsdottir, Elisabet; Grövdal, Michael; Jansson, Monika; Ben Azenkoud, Asmaa; Corddedu, Lina; Lehmann, Sören; Ekwall, Karl; Kere, Juha; Hellström-Lindberg, Eva; Ungerstedt, Johanna

    2017-04-25

    Azacitidine (Aza) is first-line treatment for patients with high-risk myelodysplastic syndromes (MDS), although its precise mechanism of action is unknown. We performed the first study to globally evaluate the epigenetic effects of Aza on MDS bone marrow progenitor cells assessing gene expression (RNA seq), DNA methylation (Illumina 450k) and the histone modifications H3K18ac and H3K9me3 (ChIP seq). Aza induced a general increase in gene expression with 924 significantly upregulated genes but this increase showed no correlation with changes in DNA methylation or H3K18ac, and only a weak association with changes in H3K9me3. Interestingly, we observed activation of transcripts containing 15 endogenous retroviruses (ERVs) confirming previous cell line studies. DNA methylation decreased moderately in 99% of all genes, with a median β-value reduction of 0.018; the most pronounced effects seen in heterochromatin. Aza-induced hypomethylation correlated significantly with change in H3K9me3. The pattern of H3K18ac and H3K9me3 displayed large differences between patients and healthy controls without any consistent pattern induced by Aza. We conclude that the marked induction of gene expression only partly could be explained by epigenetic changes, and propose that activation of ERVs may contribute to the clinical effects of Aza in MDS.

  9. Paclitaxel Induced MDS and AML: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Udit Bhaskar Bhatnagar

    2016-01-01

    Full Text Available Therapy related acute myelogenous leukemia (AML and myelodysplastic syndromes (MDS have been classically linked to alkylating agents and topoisomerase inhibitors. They constitute about 1% of all AMLs. There is less evidence on association of taxanes (paclitaxel and docetaxel with these myeloid neoplasms. We present a case of paclitaxel therapy related acute myelogenous leukemia after treatment of endometrial cancer with a regimen containing paclitaxel and carboplatin. A 63-year-old female underwent surgery followed by a total of 6 cycles of chemotherapy with carboplatin and paclitaxel. Six months after last cycle of chemotherapy, she was diagnosed with myelodysplastic syndrome with refractory anemia and excess blasts. Six weeks later, she had worsening anemia and thrombocytopenia which prompted a bone marrow biopsy which revealed acute myelomonocytic leukemia. A thorough literature review revealed 12 other case reports where taxanes have been implicated in the development of therapy related myeloid neoplasm. Based on the timeline of events in our patient, paclitaxel is the likely culprit in the pathogenesis of this myeloid neoplasm. This rare but significantly grave adverse effect should be kept in consideration when deciding on treatment options for gynecological malignancies.

  10. Investigation of porosity and fractal properties of the sintered metal and semiconductor layers in the MDS capacitor structure

    Directory of Open Access Journals (Sweden)

    Skatkov Leonid

    2012-01-01

    Full Text Available MDS capacitor (metal - dielectric - semiconductor is a structure in which metal plate is represented by compact bulk-porous pellets of niobium sintered powder, and semiconductor plate - by pyrolytic layer of MnO2. In the present paper we report the results of investigation of microporosity of sintered Nb and pyrolytic MnO2 and also the fractal properties of semiconductor layer.

  11. T-cell receptor Vbeta CDR3 oligoclonality frequently occurs in childhood refractory cytopenia (MDS-RC) and severe aplastic anemia

    DEFF Research Database (Denmark)

    Vries, A.C. de; Langerak, A.W.; Verhaaf, B.

    2008-01-01

    (Very) severe acquired aplastic anemia ((v)SAA) and myelodysplastic syndrome (MDS) are rare diseases in childhood. (V)SAA is a bone marrow (BM) failure syndrome characterized by immune-mediated destruction of hematopoietic progenitors. MDS is a malignant clonal stem cell disorder, of which...... the hypoplastic variant is, in case of absence of a cytogenetic clone, difficult to separate from (v)SAA. Recently, studies provided a molecular signature of autoimmunity in adult (v)SAA, by showing oligoclonality based on the length of the TCR Vbeta CDR3 region. We investigated retrospectively the frequency...... and the discriminative value of TCR Vbeta CDR3 oligoclonality in pediatric (v)SAA and MDS patients. Peripheral blood (PB) and/or BM mononuclear cell samples of pediatric patients with (v)SAA (n=38), refractory cytopenia (MDS-RC) (n=28) and 18 controls were analysed via TCR Vbeta heteroduplex PCR analysis of extracted...

  12. [Quality indicators for the assessment of ST-segment elevation acute myocardial infarction (STEMI) networks. How hospital discharge records could be integrated with Emergency medical services data: the Emilia-Romagna STEMI network experience].

    Science.gov (United States)

    Pavesi, Pier Camillo; Guastaroba, Paolo; Casella, Gianni; Berti, Elena; De Palma, Rossana; Di Bartolomeo, Stefano; Di Pasquale, Giuseppe

    2015-09-01

    The assessment of the regional network for ST-segment elevation acute myocardial infarction (STEMI) is fundamental for quality assurance. Since 2011 all Italian Health Authorities, in addition to hospital discharge records (HDR), must provide a standardized information flow (ERD) about emergency department (ED) and emergency medical system (EMS) activities. The aim of this study was to evaluate whether data integration of ERD with HDR may allow the development of appropriate quality indicators. Patients admitted to coronary care units (CCU) for STEMI between January 1 to December 31, 2013, were identified from the regional HDR database. All data were linked to those of the regional ERD database. Four quality indicators were defined: 1) rates of EMS activation, 2) rates of EMS direct transfer to the catheterization laboratory (Cath-lab), 3) transfer rates from a Spoke to a Hub hospital with angioplasty facilities, and 4) median time spent in ED. In 2013, 2793 patients with STEMI were admitted to the CCU. Of these, 1684 patients (60%) activated EMS and were transported to Spoke or Hub hospitals; 955 (57%) entered directly in CCU/Cath-lab; 677 were transferred directly to a Hub hospital ED without being admitted to a Spoke hospital. The median ED time in Hub hospital was 47 min (IQR 24-136) and in Spoke hospital 53 min (IQR 30-131). The integration among administrative data banks (i.e., HDR with ERD) allowed the assessment of the regional STEMI network and the identification of potentially useful quality indicators. Their easy availability should enable comparisons with local, national and international standards, and may favor quality improvement.

  13. Red Blood Cell Transfusion Dependency and Hyperferritinemia Are Associated with Impaired Survival in Patients Diagnosed with Myelodysplastic Syndromes: Results from the First Polish MDS-PALG Registry.

    Science.gov (United States)

    Waszczuk-Gajda, Anna; Mądry, Krzysztof; Machowicz, Rafał; Drozd-Sokołowska, Joanna; Stella-Hołowiecka, Beata; Mital, Andrzej; Obara, Agata; Szmigielska-Kapłon, Anna; Sikorska, Anna; Subocz, Edyta; Jędrzejczak, Wiesław W; Dwilewicz-Trojaczek, Jadwiga

    2016-01-01

    Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal stem cell disorders characterized by ineffective hematopoiesis, cytopenias and a risk of progression to acute myeloid leukemia (AML). Anemia is the most frequent cytopenia diagnosed in patients with MDS. Regular RBC transfusions are the only treatment option for about 40% of patients. Transfusion-dependent patients develop secondary iron overload. The influence of serum ferritin (SF) concentration on survival and acute myeloid leukemia transformation in MDS patients remains controversial. The data for the Central European population is scarce and so far there is no description for Poland. The aim of this study was to perform a retrospective analysis of the relationship of SF concentration with red blood cell transfusion dependency, survival and transformation to acute myeloid leukemia. We retrospectively evaluated the data of the 819 MDS patients (58% male; median age 70 years) included in the MDS Registry of the MDS Section of the Polish Adult Leukemia Group (PALG). Analyses were performed on 190 patients diagnosed with MDS, maximal 6 months before inclusion to the registry in order to avoid selection bias (a shorter survival of higher risk MDS patients). Patients with hyperferritinemia higher than 1000 ng/L vs. patients with SF concentration lower than 1000 ng/L had a median survival of 320 days vs. 568 days, respectively (p log-rank = 0.014). The following factors were found to significantly worsen survival: RBC-transfusion dependence (p = 0.0033; HR 2.67L), platelet transfusion dependence (p = 0.0071; HR 3.321), hemoglobin concentration lower than 10 g/dL (p = 0.0036; HR 2.97), SF concentration higher than 1000 ng/L (p = 0.0023; HR = 2.94), platelet count lower than 10 G/L (p = 0.0081 HR = 5.04), acute leukemia transformation (p = 0.0081; HR 1.968). Taking into account the relatively low number of patients in previous studies exploring hyperferritinemia in MDS, the results of the first Polish

  14. Estimating sediment discharge: Appendix D

    Science.gov (United States)

    Gray, John R.; Simões, Francisco J. M.

    2008-01-01

    Sediment-discharge measurements usually are available on a discrete or periodic basis. However, estimates of sediment transport often are needed for unmeasured periods, such as when daily or annual sediment-discharge values are sought, or when estimates of transport rates for unmeasured or hypothetical flows are required. Selected methods for estimating suspended-sediment, bed-load, bed- material-load, and total-load discharges have been presented in some detail elsewhere in this volume. The purposes of this contribution are to present some limitations and potential pitfalls associated with obtaining and using the requisite data and equations to estimate sediment discharges and to provide guidance for selecting appropriate estimating equations. Records of sediment discharge are derived from data collected with sufficient frequency to obtain reliable estimates for the computational interval and period. Most sediment- discharge records are computed at daily or annual intervals based on periodically collected data, although some partial records represent discrete or seasonal intervals such as those for flood periods. The method used to calculate sediment- discharge records is dependent on the types and frequency of available data. Records for suspended-sediment discharge computed by methods described by Porterfield (1972) are most prevalent, in part because measurement protocols and computational techniques are well established and because suspended sediment composes the bulk of sediment dis- charges for many rivers. Discharge records for bed load, total load, or in some cases bed-material load plus wash load are less common. Reliable estimation of sediment discharges presupposes that the data on which the estimates are based are comparable and reliable. Unfortunately, data describing a selected characteristic of sediment were not necessarily derived—collected, processed, analyzed, or interpreted—in a consistent manner. For example, bed-load data collected with

  15. Relationship between the non-motor items of the MDS-UPDRS and Quality of Life in patients with Parkinson's disease.

    Science.gov (United States)

    Skorvanek, Matej; Rosenberger, Jaroslav; Minar, Michal; Grofik, Milan; Han, Vladimir; Groothoff, Johan W; Valkovic, Peter; Gdovinova, Zuzana; van Dijk, Jitse P

    2015-01-01

    The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is a newly developed comprehensive tool to assess Parkinson's disease (PD), which covers a wider range of non-motor PD manifestations than the original UPDRS scale. The aim of this study was to assess the relationship between the MDS-UPDRS and Quality of Life (QoL) and to analyze the relationship between individual MDS-UPDRS non-motor items and QoL. A total of 291 PD patients were examined in a multicenter Slovak study. Patients were assessed by the MDS-UPDRS, HY scale and PDQ39. Data were analyzed using the multiple regression analyses. The mean participant age was 68.0 ± 9.0 years, 53.5% were men, mean disease duration was 8.3 ± 5.3 years and mean HY was 2.7 ± 1.0. In a multiple regression analysis model the PDQ39 summary index was related to MDS-UPDRS parts II, I and IV respectively, but not to part III. Individual MDS-UPDRS non-motor items related to the PDQ39 summary index in the summary group and in the non-fluctuating patients subgroup were pain, fatigue and features of dopamine dysregulation syndrome (DDS). In the fluctuating PD patient subgroup, PDQ39 was related to pain and Depressed mood items. Other MDS-UPDRS non-motor items e.g. Anxious mood, Apathy, Cognitive impairment, Hallucinations and psychosis, Sleep problems, Daytime sleepiness and Urinary problems were related to some PDQ39 domains. The overall burden of NMS in PD is more important in terms of QoL than motor symptoms. Individual MDS-UPDRS non-motor items related to worse QoL are especially pain and other sensations, fatigue and features of DDS. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Development and implementation of the waste diversion program at MDS Nordion's Cobalt Operations Facility

    International Nuclear Information System (INIS)

    Wasiak, T.

    2004-01-01

    Historically, the MDS Nordion (MDSN) Cobalt Operations Facility sent solid waste for disposal to Atomic Energy of Canada Ltd.'s Chalk River Laboratories (AECL-CRL). A large portion of this waste was not contaminated. Because this non-contaminated waste originated in the 'active area' of the MDSN facility, it was routinely disposed of as low-level active waste. In 2002, MDSN undertook an initiative to develop and implement a more sophisticated and more economical waste management program. The Waste Diversion Program (WDP) ensures continued environmental and public protection, and reduces the demand on Canada's limited capacity for storage of radioactive material and the associated operating costs. The goal of the WDP is to reduce the volume of waste currently being shipped to AECL-CRL's Waste Management Operation as low-level active waste. The presentation discusses key elements of both the development and the implementation of WDP. It focuses on the following areas: the regulatory environment surrounding the waste disposal issues in Canada and abroad. Methods used by MDSN for determination of radionuclides, which could be present in the facility. Choice of equipment and calculation of individual alarm levels for each identified radionuclide. Key elements of the practical implementation of the program. CNSC Regulatory approval process. The bottom line - dollars and cents. The primary objective of the WDP is to ensure that only waste, which meets regulatory requirements, is diverted from the solid active waste stream. This has been successfully accomplished in MDSN's Cobalt Operations Facility. The objective of the presentation is to share the knowledge and experience obtained in the development process, and thus provide a guideline for other nuclear facilities interested in establishing similar proactive and cost effective programs. (author)

  17. Adaptation of Mouse Skeletal Muscle to Long-Term Microgravity in the MDS Mission

    Science.gov (United States)

    Camerino, Giulia M.; Bianchini, Elisa; Ciciliot, Stefano; Danieli-Betto, Daniela; Dobrowolny, Gabriella; Furlan, Sandra; Germinario, Elena; Goto, Katsumasa; Gutsmann, Martina; Kawano, Fuminori; Nakai, Naoya; Ohira, Takashi; Ohno, Yoshitaka; Picard, Anne; Salanova, Michele; Schiffl, Gudrun; Blottner, Dieter; Musarò, Antonio; Ohira, Yoshinobu; Betto, Romeo; Conte, Diana; Schiaffino, Stefano

    2012-01-01

    The effect of microgravity on skeletal muscles has so far been examined in rat and mice only after short-term (5–20 day) spaceflights. The mice drawer system (MDS) program, sponsored by Italian Space Agency, for the first time aimed to investigate the consequences of long-term (91 days) exposure to microgravity in mice within the International Space Station. Muscle atrophy was present indistinctly in all fiber types of the slow-twitch soleus muscle, but was only slightly greater than that observed after 20 days of spaceflight. Myosin heavy chain analysis indicated a concomitant slow-to-fast transition of soleus. In addition, spaceflight induced translocation of sarcolemmal nitric oxide synthase-1 (NOS1) into the cytosol in soleus but not in the fast-twitch extensor digitorum longus (EDL) muscle. Most of the sarcolemmal ion channel subunits were up-regulated, more in soleus than EDL, whereas Ca2+-activated K+ channels were down-regulated, consistent with the phenotype transition. Gene expression of the atrophy-related ubiquitin-ligases was up-regulated in both spaceflown soleus and EDL muscles, whereas autophagy genes were in the control range. Muscle-specific IGF-1 and interleukin-6 were down-regulated in soleus but up-regulated in EDL. Also, various stress-related genes were up-regulated in spaceflown EDL, not in soleus. Altogether, these results suggest that EDL muscle may resist to microgravity-induced atrophy by activating compensatory and protective pathways. Our study shows the extended sensitivity of antigravity soleus muscle after prolonged exposition to microgravity, suggests possible mechanisms accounting for the resistance of EDL, and individuates some molecular targets for the development of countermeasures. PMID:22470446

  18. Adaptation of mouse skeletal muscle to long-term microgravity in the MDS mission.

    Directory of Open Access Journals (Sweden)

    Dorianna Sandonà

    Full Text Available The effect of microgravity on skeletal muscles has so far been examined in rat and mice only after short-term (5-20 day spaceflights. The mice drawer system (MDS program, sponsored by Italian Space Agency, for the first time aimed to investigate the consequences of long-term (91 days exposure to microgravity in mice within the International Space Station. Muscle atrophy was present indistinctly in all fiber types of the slow-twitch soleus muscle, but was only slightly greater than that observed after 20 days of spaceflight. Myosin heavy chain analysis indicated a concomitant slow-to-fast transition of soleus. In addition, spaceflight induced translocation of sarcolemmal nitric oxide synthase-1 (NOS1 into the cytosol in soleus but not in the fast-twitch extensor digitorum longus (EDL muscle. Most of the sarcolemmal ion channel subunits were up-regulated, more in soleus than EDL, whereas Ca(2+-activated K(+ channels were down-regulated, consistent with the phenotype transition. Gene expression of the atrophy-related ubiquitin-ligases was up-regulated in both spaceflown soleus and EDL muscles, whereas autophagy genes were in the control range. Muscle-specific IGF-1 and interleukin-6 were down-regulated in soleus but up-regulated in EDL. Also, various stress-related genes were up-regulated in spaceflown EDL, not in soleus. Altogether, these results suggest that EDL muscle may resist to microgravity-induced atrophy by activating compensatory and protective pathways. Our study shows the extended sensitivity of antigravity soleus muscle after prolonged exposition to microgravity, suggests possible mechanisms accounting for the resistance of EDL, and individuates some molecular targets for the development of countermeasures.

  19. Tennis elbow surgery - discharge

    Science.gov (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  20. Ankle replacement - discharge

    Science.gov (United States)

    ... total - discharge; Total ankle arthroplasty - discharge; Endoprosthetic ankle replacement - discharge; Osteoarthritis - ankle ... You had an ankle replacement. Your surgeon removed and reshaped ... an artificial ankle joint. You received pain medicine and were ...

  1. Hip fracture - discharge

    Science.gov (United States)

    ... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...

  2. Asthma - child - discharge

    Science.gov (United States)

    Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge ... Your child has asthma , which causes the airways of the lungs to swell and narrow. In the hospital, the doctors and nurses helped ...

  3. Prostate brachytherapy - discharge

    Science.gov (United States)

    Implant therapy - prostate cancer - discharge; Radioactive seed placement - discharge ... You had a procedure called brachytherapy to treat prostate cancer. Your treatment lasted 30 minutes or more, ...

  4. Note: A phase synchronization photography method for AC discharge

    Science.gov (United States)

    Wu, Zhicheng; Zhang, Qiaogen; Ma, Jingtan; Pang, Lei

    2018-05-01

    To research discharge physics under AC voltage, a phase synchronization photography method is presented. By using a permanent-magnet synchronous motor to drive a photography mask synchronized with a discharge power supply, discharge images in a specific phase window can be recorded. Some examples of discharges photographed by this method, including the corona discharge in SF6 and the corona discharge along the air/epoxy surface, demonstrate the feasibility of this method. Therefore, this method provides an effective tool for discharge physics researchers.

  5. Computing discharge using the index velocity method

    Science.gov (United States)

    Levesque, Victor A.; Oberg, Kevin A.

    2012-01-01

    Application of the index velocity method for computing continuous records of discharge has become increasingly common, especially since the introduction of low-cost acoustic Doppler velocity meters (ADVMs) in 1997. Presently (2011), the index velocity method is being used to compute discharge records for approximately 470 gaging stations operated and maintained by the U.S. Geological Survey. The purpose of this report is to document and describe techniques for computing discharge records using the index velocity method. Computing discharge using the index velocity method differs from the traditional stage-discharge method by separating velocity and area into two ratings—the index velocity rating and the stage-area rating. The outputs from each of these ratings, mean channel velocity (V) and cross-sectional area (A), are then multiplied together to compute a discharge. For the index velocity method, V is a function of such parameters as streamwise velocity, stage, cross-stream velocity, and velocity head, and A is a function of stage and cross-section shape. The index velocity method can be used at locations where stage-discharge methods are used, but it is especially appropriate when more than one specific discharge can be measured for a specific stage. After the ADVM is selected, installed, and configured, the stage-area rating and the index velocity rating must be developed. A standard cross section is identified and surveyed in order to develop the stage-area rating. The standard cross section should be surveyed every year for the first 3 years of operation and thereafter at a lesser frequency, depending on the susceptibility of the cross section to change. Periodic measurements of discharge are used to calibrate and validate the index rating for the range of conditions experienced at the gaging station. Data from discharge measurements, ADVMs, and stage sensors are compiled for index-rating analysis. Index ratings are developed by means of regression

  6. The development of the Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS): a large-scale data sharing initiative.

    Science.gov (United States)

    Lutomski, Jennifer E; Baars, Maria A E; Schalk, Bianca W M; Boter, Han; Buurman, Bianca M; den Elzen, Wendy P J; Jansen, Aaltje P D; Kempen, Gertrudis I J M; Steunenberg, Bas; Steyerberg, Ewout W; Olde Rikkert, Marcel G M; Melis, René J F

    2013-01-01

    In 2008, the Ministry of Health, Welfare and Sport commissioned the National Care for the Elderly Programme. While numerous research projects in older persons' health care were to be conducted under this national agenda, the Programme further advocated the development of The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS) which would be integrated into all funded research protocols. In this context, we describe TOPICS data sharing initiative (www.topics-mds.eu). A working group drafted TOPICS-MDS prototype, which was subsequently approved by a multidisciplinary panel. Using instruments validated for older populations, information was collected on demographics, morbidity, quality of life, functional limitations, mental health, social functioning and health service utilisation. For informal caregivers, information was collected on demographics, hours of informal care and quality of life (including subjective care-related burden). Between 2010 and 2013, a total of 41 research projects contributed data to TOPICS-MDS, resulting in preliminary data available for 32,310 older persons and 3,940 informal caregivers. The majority of studies sampled were from primary care settings and inclusion criteria differed across studies. TOPICS-MDS is a public data repository which contains essential data to better understand health challenges experienced by older persons and informal caregivers. Such findings are relevant for countries where increasing health-related expenditure has necessitated the evaluation of contemporary health care delivery. Although open sharing of data can be difficult to achieve in practice, proactively addressing issues of data protection, conflicting data analysis requests and funding limitations during TOPICS-MDS developmental phase has fostered a data sharing culture. To date, TOPICS-MDS has been successfully incorporated into 41 research projects, thus supporting the feasibility of constructing a large (>30,000 observations

  7. Clinical and biological significance of isolated Y chromosome loss in myelodysplastic syndromes and chronic myelomonocytic leukemia. A report from the Spanish MDS Group.

    Science.gov (United States)

    Nomdedeu, Meritxell; Pereira, Arturo; Calvo, Xavier; Colomer, Joan; Sole, Francesc; Arias, Amparo; Gomez, Candida; Luño, Elisa; Cervera, Jose; Arnan, Montserrat; Pomares, Helena; Ramos, Fernando; Oiartzabal, Itziar; Espinet, Blanca; Pedro, Carme; Arrizabalaga, Beatriz; Blanco, María Laura; Tormo, Mar; Hernandez-Rivas, Jesus Maria; Díez-Campelo, María; Ortega, Margarita; Valcárcel, David; Cedena, Maria-Teresa; Collado, Rosa; Grau, Javier; Granada, Isabel; Sanz, Guillermo; Campo, Elias; Esteve, Jordi; Costa, Dolors

    2017-12-01

    Isolate loss of chromosome Y (-Y) in myelodysplastic syndromes (MDS) is associated to a better outcome but it is also well described as an age-related phenomenon. In this study we aimed to analyze the prognostic impact of -Y in the context of the IPSS-R cytogenetic classification, evaluate the clinical significance of the percentage of metaphases with isolated -Y, and test whether finding -Y may predispose to over-diagnose MDS in patients with borderline morphological features. We evaluated 3581 male patients from the Spanish MDS Registry with a diagnosis of MDS or chronic myelomonocytic leukemia (CMML). -Y was identified in 177 patients (4.9%). Compared with the 2246 male patients with normal karyotype, -Y group showed a reduced risk of leukemic transformation that did not translate into a survival advantage. The overall survival and the risk of leukemic transformation were not influenced by the percentage of metaphases with -Y. The -Y group was not enriched in patients with minor morphologic traits of dysplasia, suggesting that the better outcome in the -Y group cannot be explained by enrichment in cases misdiagnosed as MDS. In conclusion, our results support the current recommendation of classifying patients with -Y within the very good risk category of the IPSS-R for MDS and rule out a selection bias as a possible explanation of this better outcome. An analysis of the molecular basis of MDS with isolated -Y would be of interest as it may provide a biological basis of protection against progression to acute leukemia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Thyroid function appears to be significantly reduced in Space-borne MDS mice

    Science.gov (United States)

    Saverio Ambesi-Impiombato, Francesco; Curcio, Francesco; Fontanini, Elisabetta; Perrella, Giuseppina; Spelat, Renza; Zambito, Anna Maria; Damaskopoulou, Eleni; Peverini, Manola; Albi, Elisabetta

    It is known that prolonged space flights induced changes in human cardiovascular, muscu-loskeletal and nervous systems whose function is regulated by the thyroid gland but, until now, no data were reported about thyroid damage during space missions. We have demonstrated in vitro that, during space missions (Italian Soyuz Mission "ENEIDE" in 2005, Shuttle STS-120 "ESPERIA" in 2007), thyroid in vitro cultured cells did not respond to thyroid stimulating hor-mone (TSH) treatment; they appeared healthy and alive, despite their being in a pro-apopotic state characterised by a variation of sphingomyelin metabolism and consequent increase in ce-ramide content. The insensitivity to TSH was largely due to a rearrangement of specific cell membrane microdomains, acting as platforms for TSH-receptor (TEXUS-44 mission in 2008). To study if these effects were present also in vivo, as part of the Mouse Drawer System (MDS) Tissue Sharing Program, we performed experiments in mice maintained onboard the Interna-tional Space Station during the long-duration (90 days) exploration mission STS-129. After return to earth, the thyroids isolated from the 3 animals were in part immediately frozen to study the morphological modification in space and in part immediately used to study the effect of TSH treatment. For this purpose small fragments of tissue were treated with 10-7 or 10-8 M TSH for 1 hour by using untreated fragments as controls. Then the fragments were fixed with absolute ethanol for 10 min at room temperature and centrifuged for 20 min. at 3000 x g. The supernatants were used for cAMP analysis whereas the pellet were used for protein amount determination and for immunoblotting analysis of TSH-receptor, sphingomyelinase and sphingomyelin-synthase. The results showed a modification of the thyroid structure and also the values of cAMP production after treatment with 10-7 M TSH for 1 hour were significantly lower than those obtained in Earth's gravity. The treatment with TSH

  9. 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.

  10. Therapy-Related Myelodysplastic Syndrome Following Treatment for Childhood Acute Lymphoblastic Leukemia: Outcome of Patients Registered in the EWOG-MDS 98/06 Studies

    DEFF Research Database (Denmark)

    Strahm, Birgitte; Amann, Roland; De Moerloose, Barbara

    Objective: Therapy-related myelodysplastic syndrome (tMDS) following treatment of childhood acute lymphoblastic leukemia (ALL) is one of the most frequently observed secondary malignancies in survivors of childhood cancer. Allogeneic stem cell transplantation (SCT) is the only curative treatment....... This analysis was performed to asses the outcome of patients with tMDS following treatment for childhood ALL reported to the EWOG-MDS study group. Patients and Transplant Procedure: Forty-three patients (19 male/24 female) were diagnosed with tMDS between August 1989 and August 2009. The median age at diagnosis...... was 8.9 yrs (3.4–20.5). The median interval from diagnosis of ALL to the diagnosis of tMDS was 3.3 yrs (1.7–7.0). Five patients did not receive SCT and died due to progressive disease at a median of 5.6 mo after diagnosis. Thirty-eight patients were transplanted. One patient was excluded from...

  11. Azacitidine improves outcome in higher-risk MDS patients with chromosome 7 abnormalities: a retrospective comparison of GESMD and GFM registries.

    Science.gov (United States)

    Díez-Campelo, María; Lorenzo, Jose I; Itzykson, Raphael; Rojas, Silvia M; Berthon, Céline; Luño, Elisa; Beyne-Rauzy, Odile; Perez-Oteyza, Jaime; Vey, Norbert; Bargay, Joan; Park, Sophie; Cedena, Teresa; Bordessoule, Dominique; Muñoz, Juan A; Gyan, Emmanuel; Such, Esperanza; Visanica, Sorin; López-Cadenas, Félix; de Botton, Stéphane; Hernández-Rivas, Jesús M; Ame, Shanti; Stamatoullas, Aspasia; Delaunay, Jacques; Salanoubat, Celia; Isnard, Françoise; Guieze, Romain; Pérez Guallar, Joan; Badiella, Llorenc; Sanz, Guillermo; Cañizo, Consuelo; Fenaux, Pierre

    2018-05-01

    Treatment with azacitidine (AZA) has been suggested to be of benefit for higher-risk myelodysplastic syndrome (HR-MDS) patients with chromosome 7 abnormalities (Abn 7). This retrospective study of 235 HR-MDS patients with Abn 7 treated with AZA (n = 115) versus best supportive care (BSC; n = 120), assessed AZA treatment as a time-varying variable in multivariable analysis. A Cox Regression model with time-interaction terms of overall survival (OS) at different time points confirmed that, while chromosome 7 cytogenetic categories (complex karyotype [CK] versus non-CK) and International Prognostic Scoring System risk (high versus intermediate-2) retained poor prognosis over time, AZA treatment had a favourable impact on OS during the first 3 years of treatment compared to BSC (Hazard ratio [HR] 0·5 P MDS and cytogenetic abnormalities involving chromosome 7, especially for those with CK. © 2018 John Wiley & Sons Ltd.

  12. Vessel Sewage Discharges

    Science.gov (United States)

    Vessel sewage discharges are regulated under Section 312 of the Clean Water Act, which is jointly implemented by the EPA and Coast Guard. This homepage links to information on marine sanitation devices and no discharge zones.

  13. Downregulation but lack of promoter hypermethylation or somatic mutations of the potential tumor suppressor CXXC5 in MDS and AML with deletion 5q

    DEFF Research Database (Denmark)

    Treppendahl, Marianne Bach; Möllgård, L; Hellström-Lindberg, E

    2013-01-01

    During recent years mutations in epigenetic modulators have been identified in several human cancers, including acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS)[1]. CXXC5 has been found to be necessary for retinoic acid induced differentiation of myelocytic leukemia cells, identify......During recent years mutations in epigenetic modulators have been identified in several human cancers, including acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS)[1]. CXXC5 has been found to be necessary for retinoic acid induced differentiation of myelocytic leukemia cells...

  14. Early discharge following birth

    DEFF Research Database (Denmark)

    Nilsson, Ingrid M. S.; Kronborg, Hanne; Knight, Christopher H.

    2017-01-01

    .26–0.48) and primiparous compared to multiparous had an OR of 0.22 (CI 0.17–0.29) for early discharge. Other predictors for early discharge were: no induction of labour, no epidural painkiller, bleeding less than 500 ml during delivery, higher gestational age, early expected discharge and positive breastfeeding experience...

  15. Heart attack - discharge

    Science.gov (United States)

    ... and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Deep vein thrombosis - discharge Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass ... pacemaker - discharge High blood pressure - what to ask your doctor How to read ...

  16. Myeloablative radioimmunotherapies in the conditioning of patients with AML, MDS and multiple myeloma prior to stem cell transplantation

    International Nuclear Information System (INIS)

    Buchmann, I.

    2008-01-01

    Aggressive consolidation chemotherapy and hematopoietic stem cell transplantation have improved the prognosis of patients with acute myeloid leukemia (AML), myelodyplastic syndrome (MDS) and multiple myeloma. Nevertheless, only a minor fraction of patients achieve long-term disease-free survival after stem cell transplantation with disease recurrence being the most common cause of treatment failure. In addition, therapy-related effects such as toxicity of chemotherapy and complications of stem cell transplantation increase mortality rates significantly. Myeloablative radioimmunotherapy uses radiolabeled monoclonal antibodies (mAb) with affinity for the hematopoietic marrow. It applies high radiation doses in the bone marrow but spares normal organs. Adding myeloablative radioimmunotherapy to the conditioning schemes of AML, MDS and multiple myeloma before stem cell transplantation allows for the achievement of a pronounced antileukemic/antimyeloma effect for the reduction of relapse rates without significant increase of acute organ toxicity and therapy-related mortality. In order to optimise therapy, a rational design of the nuclide-antibody combination is necessary. 90 Y, 188 Re and 131 I are the most frequently used β - -particles. Of these, 90 Y is the most qualified nuclide for myeloablation. Backbone stabilised DTPA are ideal chelators to stably conjugate 90 Y to antibodies so far. For myeloablative conditioning, anti-CD66-, -45- and -33-mAb are used. The anti-CD66-antibody BW250/183 binds to normal hematopoietic cells but not to leukemic blasts and myeloma cells. The 90 Y-2B3M-DTPA-BW250/183 is the most suited radioimmunoconjugate for patients with an infiltration grade of leukemic blasts in the bone marrow 90 Y-anti-CD45-mAb YAML568 are 6.4 ± 1.2 (bone marrow), 3.9 ± 1.4 (liver) and 1.1 ± 0.4 (kidneys). CD45 is expressed also on the extramedullar clonogenic myeloma progenitor cell that circulates in the peripheral blood. Thus, the conditioning of

  17. Decitabine improves progression-free survival in older high-risk MDS patients with multiple autosomal monosomies: results of a subgroup analysis of the randomized phase III study 06011 of the EORTC Leukemia Cooperative Group and German MDS Study Group.

    Science.gov (United States)

    Lübbert, Michael; Suciu, Stefan; Hagemeijer, Anne; Rüter, Björn; Platzbecker, Uwe; Giagounidis, Aristoteles; Selleslag, Dominik; Labar, Boris; Germing, Ulrich; Salih, Helmut R; Muus, Petra; Pflüger, Karl-Heinz; Schaefer, Hans-Eckart; Bogatyreva, Lioudmila; Aul, Carlo; de Witte, Theo; Ganser, Arnold; Becker, Heiko; Huls, Gerwin; van der Helm, Lieke; Vellenga, Edo; Baron, Frédéric; Marie, Jean-Pierre; Wijermans, Pierre W

    2016-01-01

    In a study of elderly AML patients treated with the hypomethylating agent decitabine (DAC), we noted a surprisingly favorable outcome in the (usually very unfavorable) subgroup with two or more autosomal monosomies (MK2+) within a complex karyotype (Lübbert et al., Haematologica 97:393-401, 2012). We now analyzed 206 myelodysplastic syndrome (MDS) patients (88 % of 233 patients randomized in the EORTC/GMDSSG phase III trial 06011, 61 of them with RAEBt, i.e. AML by WHO) with cytogenetics informative for MK status.. Endpoints are the following: complete/partial (CR/PR) and overall response rate (ORR) and progression-free (PFS) and overall survival (OS). Cytogenetic subgroups are the following: 63 cytogenetically normal (CN) patients, 143 with cytogenetic abnormalities, 73 of them MK-negative (MK-), and 70 MK-positive (MK+). These MK+ patients could be divided into 17 with a single autosomal monosomy (MK1) and 53 with at least two monosomies (MK2+). ORR with DAC in CN patients: 36.1 %, in MK- patients: 16.7 %, in MK+ patients: 43.6 % (MK1: 44.4 %, MK2+ 43.3 %). PFS was prolonged by DAC compared to best supportive care (BSC) in the CN (hazard ratio (HR) 0.55, 99 % confidence interval (CI), 0.26; 1.15, p = 0.03) and MK2+ (HR 0.50; 99 % CI, 0.23; 1.06, p = 0.016) but not in the MK-, MK+, and MK1 subgroups. OS was not improved by DAC in any subgroup. In conclusion, we demonstrate for the first time in a randomized phase III trial that high-risk MDS patients with complex karyotypes harboring two or more autosomal monosomies attain encouraging responses and have improved PFS with DAC treatment compared to BSC.

  18. Time to redefine PD? Introductory statement of the MDS Task Force on the definition of Parkinson's disease.

    Science.gov (United States)

    Berg, Daniela; Postuma, Ronald B; Bloem, Bastiaan; Chan, Piu; Dubois, Bruno; Gasser, Thomas; Goetz, Christopher G; Halliday, Glenda M; Hardy, John; Lang, Anthony E; Litvan, Irene; Marek, Kenneth; Obeso, José; Oertel, Wolfgang; Olanow, C Warren; Poewe, Werner; Stern, Matthew; Deuschl, Günther

    2014-04-01

    With advances in knowledge disease, boundaries may change. Occasionally, these changes are of such a magnitude that they require redefinition of the disease. In recognition of the profound changes in our understanding of Parkinson's disease (PD), the International Parkinson and Movement Disorders Society (MDS) commissioned a task force to consider a redefinition of PD. This review is a discussion article, intended as the introductory statement of the task force. Several critical issues were identified that challenge current PD definitions. First, new findings challenge the central role of the classical pathologic criteria as the arbiter of diagnosis, notably genetic cases without synuclein deposition, the high prevalence of incidental Lewy body (LB) deposition, and the nonmotor prodrome of PD. It remains unclear, however, whether these challenges merit a change in the pathologic gold standard, especially considering the limitations of alternate gold standards. Second, the increasing recognition of dementia in PD challenges the distinction between diffuse LB disease and PD. Consideration might be given to removing dementia as an exclusion criterion for PD diagnosis. Third, there is increasing recognition of disease heterogeneity, suggesting that PD subtypes should be formally identified; however, current subtype classifications may not be sufficiently robust to warrant formal delineation. Fourth, the recognition of a nonmotor prodrome of PD requires that new diagnostic criteria for early-stage and prodromal PD should be created; here, essential features of these criteria are proposed. Finally, there is a need to create new MDS diagnostic criteria that take these changes in disease definition into consideration. © 2014 International Parkinson and Movement Disorder Society.

  19. Relationship between the non-motor items of the MDS-UPDRS and Quality of Life in patients with Parkinson's disease

    NARCIS (Netherlands)

    Skorvanek, Matej; Rosenberger, Jaroslav; Minar, Michal; Grofik, Milan; Han, Vladimir; Groothoff, Johan W.; Valkovic, Peter; Gdovinova, Zuzana; van Dijk, Jitse P.

    2015-01-01

    The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is a newly developed comprehensive tool to assess Parkinson's disease (PD), which covers a wider range of non-motor PD manifestations than the original UPDRS scale. The aim of this study was to assess the relationship

  20. CMS MDS 3.0 Section M Skin Conditions in Long-term Care: Pressure Ulcers, Skin Tears, and Moisture-Associated Skin Damage Data Update.

    Science.gov (United States)

    Ayello, Elizabeth A

    2017-09-01

    The purpose of this learning activity is to provide information about the updates to the Centers for Medicare & Medicaid Services (CMS) MDS 3.0 Section M, Skin Conditions documentation in long-term care. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Explain the use of the CMS MDS 3.0 tool for documenting skin problems in long-term care.2. Demonstrate examples of proper documentation for specific skin problems. This manuscript reviews some of the key parts of the October 2016 revised Long-term Care Resident Assessment Instrument manual for Minimum Data Set (MDS) 3.0 Section M Skin Conditions. It also reports the Centers for Medicare & Medicaid's publicly reported frequency data in long-term care for selected items on the MDS 3.0 Section M Skin Conditions. Percentages and trends of pressure ulcers/injuries, skin tears, and moisture-associated skin damage are assessed.

  1. Impact of chromosome alterations, genetic mutations and clonal hematopoiesis of indeterminate potential (CHIP) on the classification and risk stratification of MDS.

    Science.gov (United States)

    Ganguly, Bani Bandana; Banerjee, Debasis; Agarwal, Mohan B

    2018-03-01

    The advent of technological development has undoubtedly advanced biological and molecular inputs for better understanding the heterogeneous hematopoietic pre-malignant disorder of the stem cells known as myelodysplastic syndromes (MDS). Chromosomal rearrangements, including del(3q/5q/7q/11q/12p/20q), loss of 5/7/Y, trisomy 8/19, i(17q), etc. frequently detected in MDS with variable frequencies and combinations, are the integral components of the 5-tier risk-stratification and WHO-2016 classification. Observations on mutations in genes involved in RNA-splicing, DNA methylation, chromatin modification, transcription factor, signal transduction/kinases, RAS pathway, cohesin complex, DNA repair and other pathways have given insights in independent effects and biological interaction of co-occurrence on disease-phenotype and treatment outcome. However, recent concepts of clonal hematopoiesis of indeterminate potential (CHIP) and idiopathic cytopenia of undetermined significance (ICUS) have urged a re-definition of mutational events in non-clonal cytopenia and non-MDS healthy elderly but with a higher risk of overt leukemia. Considering gene mutations, chromosomal alterations, CHIP, ICUS and their significance in classification and risk-scoring certainly presents a comprehensive picture of disease-phenotype towards better understanding of MDS-pathogenesis, its evolution to AML and its response to therapeutic agents. The present review summarizes chromosomal and gene mutations, co-existence of mutational complexity, and WHO-2016 classification and risk-stratifications of MDS to facilitate a better understanding of its pathogenesis. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Safety and efficacy of the CD95-ligand inhibitor asunercept in transfusion-dependent patients with low and intermediate risk MDS.

    Science.gov (United States)

    Boch, Tobias; Luft, Thomas; Metzgeroth, Georgia; Mossner, Maximilian; Jann, Johann-Christoph; Nowak, Daniel; Meir, Franziska La; Schumann, Christiane; Klemmer, Jennifer; Brendel, Susanne; Fricke, Harald; Kunz, Claudia; Weiß, Christel; Hofmann, Wolf-Karsten; Nolte, Florian

    2018-05-01

    In low risk MDS, increased apoptosis of erythroid progenitors mediated via CD95 (Fas) activation has been described to result in peripheral cytopenia. Blockade of the CD95 system can improve erythropoiesis in MDS. Asunercept (APG101) is a fusion protein consisting of the extracellular domain of human CD95 and the Fc domain of human IgG1 blocking the interaction between CD95 and its ligand. Here we report on results from a phase I study in 20 transfusion-dependent low and intermediate risk MDS patients treated with intravenous asunercept (EudraCT 2012-003027-37). Primary objectives were safety and tolerability as well as pharmacodynamic effects. Secondary objectives were hematologic improvement, incidence and time to leukemic progression as well as overall survival. Frequency and severity of adverse events were in range of what could be expected in a patient cohort comprising of elderly MDS patients. Two patients experienced a serious adverse event with a suspected relationship to asunercept. The incidence of disease progression was low. In the 20 patients a decrease of the transfusion need from a mean of 10,8 (±5,1) pRBCs during the 12 weeks treatment phase to a mean of 10,0 (±4,2) pRBCs at the end of the study was observed. In conclusion, asunercept was well tolerated and showed efficacy in transfusion-dependent low and intermediate risk MDS patients. Further clinical investigation is warranted, particularly in combination with erythropoiesis stimulating agents (ESAs). Copyright © 2018. Published by Elsevier Ltd.

  3. Age-related changes of healthy bone marrow cell signaling in response to growth factors provide insight into low risk MDS.

    Science.gov (United States)

    Kornblau, Steven M; Cohen, Aileen C; Soper, David; Huang, Ying-Wen; Cesano, Alessandra

    2014-11-01

    Single Cell Network Profiling (SCNP) is a multiparametric flow cytometry-based assay that quantifiably and simultaneously measures changes in intracellular signaling proteins in response to in vitro extracellular modulators at the single cell level. Myelodysplastic syndrome (MDS) is a heterogeneous clonal disorder of hematopoietic stem cells that occurs in elderly subjects and is characterized by dysplasia and ineffective hematopoiesis. The functional responsiveness of MDS bone marrow (BM) hematopoietic cells, including functionally distinct myeloid and erythroid precursor subsets, to hematopoietic growth factors (HGF) and the relationship of modulated signaling to disease characteristics is poorly understood. SCNP was used first to examine the effects of age on erythropoietin (EPO) and granulocyte colony stimulating factor (GCSF)-induced signaling in myeloid, nucleated red blood cells (nRBC), and CD34 expressing cell subsets in healthy BM (n = 15). SCNP was then used to map functional signaling profiles in low risk (LR) MDS (n = 7) for comparison to signaling in samples from healthy donors and to probe signaling associations within clinically defined subgroups. In healthy BM samples, signaling responses to HGF were quite homogeneous (i.e., tightly regulated) with age-dependent effects observed in response to EPO but not to GCSF. Despite the relatively small number of samples assayed in the study, LR MDS could be classified into distinct subgroups based on both cell subset frequency and signaling profiles. As a correlate of underlying genetic abnormalities, signal transduction analyses may provide a functional and potentially clinically relevant classification of MDS. Further evaluation in a larger cohort is warranted. © 2013 Clinical Cytometry Society.

  4. The value of oxygen-isotope data and multiple discharge records in calibrating a fully-distributed, physically-based rainfall-runoff model (CRUM3) to improve predictive capability

    Science.gov (United States)

    Neill, Aaron; Reaney, Sim

    2015-04-01

    Fully-distributed, physically-based rainfall-runoff models attempt to capture some of the complexity of the runoff processes that operate within a catchment, and have been used to address a variety of issues including water quality and the effect of climate change on flood frequency. Two key issues are prevalent, however, which call into question the predictive capability of such models. The first is the issue of parameter equifinality which can be responsible for large amounts of uncertainty. The second is whether such models make the right predictions for the right reasons - are the processes operating within a catchment correctly represented, or do the predictive abilities of these models result only from the calibration process? The use of additional data sources, such as environmental tracers, has been shown to help address both of these issues, by allowing for multi-criteria model calibration to be undertaken, and by permitting a greater understanding of the processes operating in a catchment and hence a more thorough evaluation of how well catchment processes are represented in a model. Using discharge and oxygen-18 data sets, the ability of the fully-distributed, physically-based CRUM3 model to represent the runoff processes in three sub-catchments in Cumbria, NW England has been evaluated. These catchments (Morland, Dacre and Pow) are part of the of the River Eden demonstration test catchment project. The oxygen-18 data set was firstly used to derive transit-time distributions and mean residence times of water for each of the catchments to gain an integrated overview of the types of processes that were operating. A generalised likelihood uncertainty estimation procedure was then used to calibrate the CRUM3 model for each catchment based on a single discharge data set from each catchment. Transit-time distributions and mean residence times of water obtained from the model using the top 100 behavioural parameter sets for each catchment were then compared to

  5. Myeloablative radioimmunotherapies in the conditioning of patients with AML, MDS and multiple myeloma prior to stem cell transplantation; Myeloablative Radioimmuntherapien zur Konditionierung bei Patienten mit AML, MDS und multiplem Myelom vor Stammzelltransplantation

    Energy Technology Data Exchange (ETDEWEB)

    Buchmann, I. [Abt. fuer Nuklearmedizin, Universitaetsklinik Heidelberg (Germany)

    2008-06-15

    Aggressive consolidation chemotherapy and hematopoietic stem cell transplantation have improved the prognosis of patients with acute myeloid leukemia (AML), myelodyplastic syndrome (MDS) and multiple myeloma. Nevertheless, only a minor fraction of patients achieve long-term disease-free survival after stem cell transplantation with disease recurrence being the most common cause of treatment failure. In addition, therapy-related effects such as toxicity of chemotherapy and complications of stem cell transplantation increase mortality rates significantly. Myeloablative radioimmunotherapy uses radiolabeled monoclonal antibodies (mAb) with affinity for the hematopoietic marrow. It applies high radiation doses in the bone marrow but spares normal organs. Adding myeloablative radioimmunotherapy to the conditioning schemes of AML, MDS and multiple myeloma before stem cell transplantation allows for the achievement of a pronounced antileukemic/antimyeloma effect for the reduction of relapse rates without significant increase of acute organ toxicity and therapy-related mortality. In order to optimise therapy, a rational design of the nuclide-antibody combination is necessary. {sup 90}Y, {sup 188}Re and {sup 131}I are the most frequently used {beta}{sup -}-particles. Of these, {sup 90}Y is the most qualified nuclide for myeloablation. Backbone stabilised DTPA are ideal chelators to stably conjugate {sup 90}Y to antibodies so far. For myeloablative conditioning, anti-CD66-, -45- and -33-mAb are used. The anti-CD66-antibody BW250/183 binds to normal hematopoietic cells but not to leukemic blasts and myeloma cells. The {sup 90}Y-2B3M-DTPA-BW250/183 is the most suited radioimmunoconjugate for patients with an infiltration grade of leukemic blasts in the bone marrow < 25%. The specific doses (Gy/GBq) are 10.2 {+-} 1.8 (bone marrow), 2.7 {+-} 2 (liver) and < 1 (kidneys). In contrast, radiolabeled anti-CD33- and anti-CD45-antibodies bind to both, most of white blood cells and

  6. Glow discharging device

    International Nuclear Information System (INIS)

    Maeno, Katsuki; Kawasaki, Kozo; Hiratsuka, Hajime; Kawashima, Shuichi.

    1989-01-01

    In a thermonuclear device, etc. impurities adsorbed to inner walls of a vacuum vessel by glow discharge are released to clean the vacuum vessel for preventing intrusion of the impurities into plasmas. The object of the present invention is to minimize the capacity of a power source equipment for the glow discharge device to the least extent. That is, a stabilization resistance is connected in series between each of a plurality of anodes which are inserted and arranged at the inside of a vacuum vessel as a cathode and a power source respectively. The resistance value R is selected so as to satisfy the relation: R < (Vi - Vm)/Ii, in which Vi: glow discharge starting voltage, Vm: glow discharge keeping voltage, Ii: glow discharge starting current. Accordingly, if a voltage is applied from a power source to a plurality of anodes, scattering of electric discharge between the anodes can be suppressed and the effect of voltage drop during discharge by the stabilization resistance can be eliminated. As a result, it is possible to provide an economically advantageous glow discharge device with the capacity for the power source facility being to the least extent. (K.M.)

  7. CO-AXIAL DISCHARGES

    Science.gov (United States)

    Luce, J.S.; Smith, L.P.

    1960-11-22

    A method and apparatus are given for producing coaxial arc discharges in an evacuated enclosure and within a strong, confining magnetic field. The arcs are maintained at a high potential difference. Electrons will diffuse to the more positive arc from the negative arc, and positive ions will diffuse from the more positive arc to the negative arc. Coaxial arc discharges have the advantage that ions which return to strike the positive arc discharge will lose no energy since they do not strike a solid wall or electrode. Those discharges are useful in confining an ionized plasma between the discharges, and have the advantage of preventing impurities from the walls of the enclosure from entering ihe plasma area because of the arc barrier set up bv the cylindrical outer arc.

  8. Design and rationale of the QUAZAR Lower-Risk MDS (AZA-MDS-003) trial: a randomized phase 3 study of CC-486 (oral azacitidine) plus best supportive care vs placebo plus best supportive care in patients with IPSS lower-risk myelodysplastic syndromes and poor prognosis due to red blood cell transfusion-dependent anemia and thrombocytopenia.

    Science.gov (United States)

    Garcia-Manero, Guillermo; Almeida, Antonio; Giagounidis, Aristoteles; Platzbecker, Uwe; Garcia, Regina; Voso, Maria Teresa; Larsen, Stephen R; Valcarcel, David; Silverman, Lewis R; Skikne, Barry; Santini, Valeria

    2016-01-01

    CC-486 is an oral formulation of the epigenetic modifier azacitidine. In an expanded phase 1 trial, CC-486 demonstrated clinical and biological activity in patients with International Prognostic Scoring System (IPSS) lower-risk (low- and intermediate-1-risk) myelodysplastic syndromes (MDS) with poor prognostic features including anemia and/or thrombocytopenia who may have required red blood cell or platelet transfusions. The overall response rate was 40 %, including hematologic improvement in 28 % of patients and RBC transfusion independence sustained for 56 days in 47 % of patients with baseline transfusion dependence. Based on the results of this study, the randomized, placebo-controlled phase 3 QUAZAR Lower-Risk MDS trial (AZA-MDS-003) was initiated. The design and rationale for this trial comparing CC-486 with placebo for the treatment of patients with IPSS lower-risk MDS with poor prognostic features are described. Patients must have IPSS lower-risk MDS with red blood cell (RBC) transfusion-dependent anemia and thrombocytopenia. Eligible patients are randomized 1:1 to receive 300 mg of CC-486 or placebo once daily for the first 21 days of 28-day treatment cycles. Disease status assessments occur at the end of cycle 6 and patients may continue to receive treatment unless there is evidence of progressive disease, lack of efficacy, or unacceptable toxicity. The primary endpoint is RBC transfusion independence for ≥ 84 days, assessed according to International Working Group 2006 criteria. Secondary endpoints include overall survival, hematologic response including platelet response and erythroid response, RBC transfusion independence for ≥ 56 days, duration of RBC transfusion independence, time to RBC transfusion independence, rate of acute myeloid leukemia (AML) progression, time to AML progression, clinically significant bleeding events, safety, health-related quality of life, and healthcare resource utilization. This study will provide data

  9. Modelling electric discharge chemistry

    International Nuclear Information System (INIS)

    McFarlane, J.; Wren, J.C.

    1991-07-01

    The chemistry occurring in a electric discharge was modelled to predict how it would be influenced by discharge conditions. The discharge was characterized by a calculated Boltzmann electron-energy distribution, from which rate constants for electron-molecule processes in air were determined. These rate constants were used in a chemical kinetics calculation that also included reactions between neutral molecules, ions, free radicals and electronically excited species. The model describes how the discharge chemistry was influenced by humidity, electric field, electron number density, and concentrations of key reagents identified in the study. The use of an electric discharge to destroy airborne contaminant molecules was appraised, the targeted contaminants being CF 2 Cl 2 , HCN, and SO 2 . The modelling results indicate that an electric discharge should be able to remove HCN and CF 2 Cl 2 effectively, especially if the discharge conditions have been optimized. Effective destruction is achieved with a moderate electric field (over 1 x 10 -15 V.cm 2 ), a substantial electron number density (over 1 x 10 12 cm -3 ), and the presence of H 2 0 in the process air. The residence time in the discharge was also shown to be important in contaminant destruction. An attempt was made to explain the results of the electric discharge abatement of SO 2 , a component of a simulated flue-gas mixture. Results from the model indicate that the discharge parameters that increase the concentration of hydroxyl radical also increase the rate of decomposition of SO 2 . An objective of the study was to explain the apparent enhancement of SO 2 destruction by the presence of a small amount of NO 2 . It was thought that a likely explanation would be the stabilization of HOSO 2 , an important intermediate in the oxidation of SO 2 by NO 2 . (49 figs., 14 tabs., 75 refs.)

  10. Discharge lamp technologies

    Science.gov (United States)

    Dakin, James

    1994-01-01

    This talk is an overview of discharge lamp technology commonly employed in general lighting, with emphasis on issues pertinent to lighting for plant growth. Since the audience is primarily from the plant growth community, and this begins the light source part of the program, we will start with a brief description of the discharge lamps. Challenges of economics and of thermal management make lamp efficiency a prime concern in controlled environment agriculture, so we will emphasize science considerations relating to discharge lamp efficiency. We will then look at the spectra and ratings of some representative lighting products, and conclude with a discussion of technological advances.

  11. Capacitor discharge engineering

    CERN Document Server

    Früngel, Frank B A

    1976-01-01

    High Speed Pulse Technology, Volume III: Capacitor Discharge Engineering covers the production and practical application of capacitor dischargers for the generation and utilization of high speed pulsed of energy in different forms. This nine-chapter volume discusses the principles of electric current, voltage, X-rays, gamma rays, heat, beams of electrons, neutrons and ions, magnetic fields, sound, and shock waves in gases and liquids. Considerable chapters consider the applications of capacitor discharges, such as impulse hardening of steel, ultrapulse welding of precision parts, X-ray flash t

  12. Predicting tile drainage discharge

    DEFF Research Database (Denmark)

    Iversen, Bo Vangsø; Kjærgaard, Charlotte; Petersen, Rasmus Jes

    used in the analysis. For the dynamic modelling, a simple linear reservoir model was used where different outlets in the model represented tile drain as well as groundwater discharge outputs. This modelling was based on daily measured tile drain discharge values. The statistical predictive model...... was based on a polynomial regression predicting yearly tile drain discharge values using site specific parameters such as soil type, catchment topography, etc. as predictors. Values of calibrated model parameters from the dynamic modelling were compared to the same site specific parameter as used...

  13. MM-MDS: a multidimensional scaling database with similarity ratings for 240 object categories from the Massive Memory picture database.

    Directory of Open Access Journals (Sweden)

    Michael C Hout

    Full Text Available Cognitive theories in visual attention and perception, categorization, and memory often critically rely on concepts of similarity among objects, and empirically require measures of "sameness" among their stimuli. For instance, a researcher may require similarity estimates among multiple exemplars of a target category in visual search, or targets and lures in recognition memory. Quantifying similarity, however, is challenging when everyday items are the desired stimulus set, particularly when researchers require several different pictures from the same category. In this article, we document a new multidimensional scaling database with similarity ratings for 240 categories, each containing color photographs of 16-17 exemplar objects. We collected similarity ratings using the spatial arrangement method. Reports include: the multidimensional scaling solutions for each category, up to five dimensions, stress and fit measures, coordinate locations for each stimulus, and two new classifications. For each picture, we categorized the item's prototypicality, indexed by its proximity to other items in the space. We also classified pairs of images along a continuum of similarity, by assessing the overall arrangement of each MDS space. These similarity ratings will be useful to any researcher that wishes to control the similarity of experimental stimuli according to an objective quantification of "sameness."

  14. MM-MDS: a multidimensional scaling database with similarity ratings for 240 object categories from the Massive Memory picture database.

    Science.gov (United States)

    Hout, Michael C; Goldinger, Stephen D; Brady, Kyle J

    2014-01-01

    Cognitive theories in visual attention and perception, categorization, and memory often critically rely on concepts of similarity among objects, and empirically require measures of "sameness" among their stimuli. For instance, a researcher may require similarity estimates among multiple exemplars of a target category in visual search, or targets and lures in recognition memory. Quantifying similarity, however, is challenging when everyday items are the desired stimulus set, particularly when researchers require several different pictures from the same category. In this article, we document a new multidimensional scaling database with similarity ratings for 240 categories, each containing color photographs of 16-17 exemplar objects. We collected similarity ratings using the spatial arrangement method. Reports include: the multidimensional scaling solutions for each category, up to five dimensions, stress and fit measures, coordinate locations for each stimulus, and two new classifications. For each picture, we categorized the item's prototypicality, indexed by its proximity to other items in the space. We also classified pairs of images along a continuum of similarity, by assessing the overall arrangement of each MDS space. These similarity ratings will be useful to any researcher that wishes to control the similarity of experimental stimuli according to an objective quantification of "sameness."

  15. Improving prediction of fall risk among nursing home residents using electronic medical records.

    Science.gov (United States)

    Marier, Allison; Olsho, Lauren E W; Rhodes, William; Spector, William D

    2016-03-01

    Falls are physically and financially costly, but may be preventable with targeted intervention. The Minimum Data Set (MDS) is one potential source of information on fall risk factors among nursing home residents, but its limited breadth and relatively infrequent updates may limit its practical utility. Richer, more frequently updated data from electronic medical records (EMRs) may improve ability to identify individuals at highest risk for falls. The authors applied a repeated events survival model to analyze MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain that uses a centralized EMR system from a leading vendor. Estimated regression parameters were used to project resident fall probability. The authors examined the proportion of observed falls within each projected fall risk decile to assess improvements in predictive power from including EMR data. In a model incorporating fall risk factors from the MDS only, 28.6% of observed falls occurred among residents in the highest projected risk decile. In an alternative specification incorporating more frequently updated measures for the same risk factors from the EMR data, 32.3% of observed falls occurred among residents in the highest projected risk decile, a 13% increase over the base MDS-only specification. Incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone. These improvements stem chiefly from the greater frequency with which EMR data are updated, with minimal additional gains from availability of additional risk factor variables. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Electric discharge during electrosurgery.

    Science.gov (United States)

    Shashurin, Alexey; Scott, David; Zhuang, Taisen; Canady, Jerome; Beilis, Isak I; Keidar, Michael

    2015-04-16

    Electric discharge utilized for electrosurgery is studied by means of a recently developed method for the diagnostics of small-size atmospheric plasma objects based on Rayleigh scattering of microwaves on the plasma volume. Evolution of the plasma parameters in the near-electrode sheaths and in the positive column is measured and analyzed. It is found that the electrosurgical system produces a glow discharge of alternating current with strongly contracted positive column with current densities reaching 10(3) A/cm(2). The plasma electron density and electrical conductivities in the channel were found be 10(16) cm(-3) and (1-2) Ohm(-1) cm(-1), respectively. The discharge interrupts every instance when the discharge-driving AC voltage crosses zero and re-ignites again every next half-wave at the moment when the instant voltage exceeds the breakdown threshold.

  17. Vaginal delivery - discharge

    Science.gov (United States)

    Pregnancy - discharge after vaginal delivery ... You may have bleeding from your vagina for up to 6 weeks. Early on, you may pass some small clots when you first get up. Bleeding will slowly become ...

  18. Prostate radiation - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000399.htm Prostate radiation - discharge To use the sharing features on ... keeping or getting an erection may occur after prostate radiation therapy. You may not notice this problem ...

  19. Brain injury - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000163.htm Brain injury - discharge To use the sharing features on ... know was in the hospital for a serious brain injury. At home, it will take time for ...

  20. Brain aneurysm repair - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000123.htm Brain aneurysm repair - discharge To use the sharing features ... this page, please enable JavaScript. You had a brain aneurysm . An aneurysm is a weak area in ...

  1. Brain radiation - discharge

    Science.gov (United States)

    Radiation - brain - discharge; Cancer - brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation ... Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling ...

  2. Atrial fibrillation - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000237.htm Atrial fibrillation - discharge To use the sharing features on this ... have been in the hospital because you have atrial fibrillation . This condition occurs when your heart beats faster ...

  3. Pneumonia - adults - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000017.htm Pneumonia in adults - discharge To use the sharing features on this page, please enable JavaScript. You have pneumonia, which is an infection in your lungs. In ...

  4. Knee arthroscopy - discharge

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000199.htm Knee arthroscopy - discharge To use the sharing features on this ... surgery to treat problems in your knee (knee arthroscopy). You may have been checked for: Torn meniscus. ...

  5. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  6. Shoulder surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000179.htm Shoulder surgery - discharge To use the sharing features on this page, please enable JavaScript. You had shoulder surgery to repair the tissues inside or around your ...

  7. Multidimensional assessment of patient condition and mutational analysis in peripheral blood, as tools to improve outcome prediction in myelodysplastic syndromes: A prospective study of the Spanish MDS group.

    Science.gov (United States)

    Ramos, Fernando; Robledo, Cristina; Pereira, Arturo; Pedro, Carmen; Benito, Rocío; de Paz, Raquel; Del Rey, Mónica; Insunza, Andrés; Tormo, Mar; Díez-Campelo, María; Xicoy, Blanca; Salido, Eduardo; Sánchez-Del-Real, Javier; Arenillas, Leonor; Florensa, Lourdes; Luño, Elisa; Del Cañizo, Consuelo; Sanz, Guillermo F; María Hernández-Rivas, Jesús

    2017-09-01

    The International Prognostic Scoring System and its revised form (IPSS-R) are the most widely used indices for prognostic assessment of patients with myelodysplastic syndromes (MDS), but can only partially account for the observed variation in patient outcomes. This study aimed to evaluate the relative contribution of patient condition and mutational status in peripheral blood when added to the IPSS-R, for estimating overall survival and the risk of leukemic transformation in patients with MDS. A prospective cohort (2006-2015) of 200 consecutive patients with MDS were included in the study series and categorized according to the IPSS-R. Patients were further stratified according to patient condition (assessed using the multidimensional Lee index for older adults) and genetic mutations (peripheral blood samples screened using next-generation sequencing). The change in likelihood-ratio was tested in Cox models after adding individual covariates. The addition of the Lee index to the IPSS-R significantly improved prediction of overall survival [hazard ratio (HR) 3.02, 95% confidence interval (CI) 1.96-4.66, P < 0.001), and mutational analysis significantly improved prediction of leukemic evolution (HR 2.64, 1.56-4.46, P < 0.001). Non-leukemic death was strongly linked to patient condition (HR 2.71, 1.72-4.25, P < 0.001), but not to IPSS-R score (P = 0.35) or mutational status (P = 0.75). Adjustment for exposure to disease-modifying therapy, evaluated as a time-dependent covariate, had no effect on the proposed model's predictive ability. In conclusion, patient condition, assessed by the multidimensional Lee index and patient mutational status can improve the prediction of clinical outcomes of patients with MDS already stratified by IPSS-R. © 2017 Wiley Periodicals, Inc.

  8. Large enhancement of highly energetic electrons in the outer radiation belt and its transport into the inner radiation belt inferred from MDS-1 satellite observations

    Science.gov (United States)

    Obara, T.; Matsumoto, H.

    2016-03-01

    We have examined a large increase of relativistic electrons in the outer radiation belt and its penetration into the inner radiation belt over slot region using the MDS-1 satellite observations. Result of analyses demonstrates that a large increase took place in the spring and autumn seasons, and we have newly confirmed that the penetration of outer belt electrons to the inner radiation zone took place during the big magnetic storms by examining a pitch angle distribution of the penetrating electrons.

  9. Discharges for lighting

    International Nuclear Information System (INIS)

    Stoffels, W W; Nimalasuriya, T; Flikweert, A J; Mulders, H C J

    2007-01-01

    The most common man-made discharge is a lamp. Even though lamps are often considered a mature technology, the discharge physics is often poorly understood. Two recent initiatives discussed here show that plasma research can help to make significant improvements. First we discuss color separation in metal halide lamps, which is a problem that prevents these highly efficient lamps from being used in more applications. Secondly a novel lamp concept is presented that may replace the current mercury based fluorescent lamps

  10. Toward a new task assignment and path evolution (TAPE) for missile defense system (MDS) using intelligent adaptive SOM with recurrent neural networks (RNNs).

    Science.gov (United States)

    Wang, Chi-Hsu; Chen, Chun-Yao; Hung, Kun-Neng

    2015-06-01

    In this paper, a new adaptive self-organizing map (SOM) with recurrent neural network (RNN) controller is proposed for task assignment and path evolution of missile defense system (MDS). We address the problem of N agents (defending missiles) and D targets (incoming missiles) in MDS. A new RNN controller is designed to force an agent (or defending missile) toward a target (or incoming missile), and a monitoring controller is also designed to reduce the error between RNN controller and ideal controller. A new SOM with RNN controller is then designed to dispatch agents to their corresponding targets by minimizing total damaging cost. This is actually an important application of the multiagent system. The SOM with RNN controller is the main controller. After task assignment, the weighting factors of our new SOM with RNN controller are activated to dispatch the agents toward their corresponding targets. Using the Lyapunov constraints, the weighting factors for the proposed SOM with RNN controller are updated to guarantee the stability of the path evolution (or planning) system. Excellent simulations are obtained using this new approach for MDS, which show that our RNN has the lowest average miss distance among the several techniques.

  11. Discharge lamp technologies

    Energy Technology Data Exchange (ETDEWEB)

    Dakin, J. [GE Lighting, Cleveland, OH (United States)

    1994-12-31

    This talk is an overview of discharge lamp technology commonly employed in general lighting, with emphasis on issues pertinent to lighting for plant growth. Since the audience is primarily from the plant growth community, and this begins the light source part of the program, we will start with a brief description of the discharge lamps. Challenges of economics and of thermal management make lamp efficiency a prime concern in controlled environment agriculture, so we will emphasize science considerations relating to discharge lamp efficiency. We will then look at the spectra and ratings of some representative lighting products, and conclude with a discussion of technological advance. A general overview of discharge lighting technology can be found in the book of Waymouth (1971). A recent review of low pressure lighting discharge science is found in Dakin (1991). The pioneering paper of Reiling (1964) provides a good introduction to metal halide discharges. Particularly relevant to lighting for plant growth, a recent and thorough treatment of high pressure Na lamps is found in the book by deGroot and vanVliet (1986). Broad practical aspects of lighting application are thoroughly covered in the IES Lighting Handbook edited by Kaufman (1984).

  12. Chaos in gas discharges

    International Nuclear Information System (INIS)

    Piel, A.

    1993-01-01

    Many gas discharges exhibit natural oscillations which undergo a transition from regular to chaotic behavior by changing an experimental parameter or by applying external modulation. Besides several isolated investigations, two classes of discharge phenomena have been studied in more detail: ionization waves in medium pressure discharges and potential relaxation oscillations in filament cathode discharges at very low pressure. The latter phenomenon will be discussed by comparing experimental results from different discharge arrangements with particle-in-cell simulations and with a model based on the van-der-Pol equation. The filament cathode discharge has two stable modes of operation: the low current anode-glow-mode and the high current temperature-limited-mode, which form the hysteresis curve in the I(U) characteristics. Close to the hysteresis point of the AGM periodic relaxation oscillations occur. The authors demonstrate that the AGM can be understood by ion production in the anode layer, stopping of ions by charge exchange, and trapping in the virtual cathode around the filament. The relaxation oscillations consist of a slow filling phase and a rapid phase that invokes formation of an unstable double-layer, current-spiking, and ion depletion from the cathodic plasma. The relaxation oscillations can be mode-locked by external modulation. Inside a mode-locked state, a period doubling cascade is observed at high modulation degree

  13. MDS G(N) fast differentiation between natural and artificial gamma radiation with a new class of mobile instruments

    International Nuclear Information System (INIS)

    Katzung, W.; Bottcher, J.

    2009-01-01

    A State-of-the-Art tool used for detecting and tracking artificial gamma radiation out of a helicopter or a vehicle is the MDS G(N) - Mobile Detection System. A highly sensitive scintillation detector detects a significant artificial gamma radiation on the ground even if the helicopter is travelling at high speed. The GPS-aided system visualizes the measured values on a moveable map displayed on the screen of a notebook every second. The colours of the continuously entered points do represent adjustable alarm thresholds. This way, location and intensity of an unknown radioactive source or a radioactive contamination can be determined very quickly. The NBR-technology (Natural Background Rejection) which is used here leads to expressive measurement results differentiating between artificial and natural gamma radiation. Additional He-3 detectors allow simultaneously the detection of neutrons. The NBR principle - developed by Thermo Scientific - stands out for its very short response times. Thus, artificial radiation can be detected reliably within seconds - even when the unit is operated by untrained staff. Unlike traditional analytic measuring techniques, the NBR method is able to detect artificial radiation sources hidden or strongly shielded gamma sources clearly from the natural background radiation. The measuring range from 1 nSv/h to 20 ?Sv/h and is extended to 1 Sv/h with a Geiger Mueller counting tube. The sensitivity amounts to max. 20000 cps (referred to 1 ?Sv/h for Cs-137). The NBR- technique is well-proven and tested for: tracking hidden radiation sources, even such ones with low activity or which are shielded, detection of artificial radiation portions in the range of the natural background, reliably measuring the ambient equivalent dose rate in the range of the natural background, fast detection of artificial radioactivity out of helicopters and vehicles.(author)

  14. Multipactor discharge apparatus

    International Nuclear Information System (INIS)

    1976-01-01

    The invention deals with a multipactor discharge apparatus which can be used for tuning microwave organs such as magnetron oscillators and other cavity resonators. This apparatus is suitable for delivering an improved tuning effect in a resonation organ wherefrom the working frequency must be set. This apparatus is equipped with two multipactor discharge electrodes set in a configuration such to that a net current flows from one electrode to another. These electrodes are parallel and flat. The apparatus can be used in magnetron devices as well for continuous waves as for impulses

  15. Red herring vaginal discharge.

    Science.gov (United States)

    Lee, Jun Hee; Pringle, Kirsty; Rajimwale, Ashok

    2013-09-18

    Labial hair tourniquet syndrome is a rare condition that can be easily misdiagnosed and ultimately lead to irreversible damage. An 11-year-old premenarche girl presented with a 5-day history of pain and swelling in the labia with associated vaginal discharge. The general practitioner treated her with clotrimazole without improvement. On examination, there was an oedematous swelling of the right labia with a proximal hair tourniquet. Local anaesthetic was applied and the hair removed with forceps. There was instant relief of pain and the discharge stopped within 24 h. The patient was sent home with a course of antibiotics.

  16. Travelling-wave-sustained discharges

    International Nuclear Information System (INIS)

    Schlueter, Hans; Shivarova, Antonia

    2007-01-01

    This review is on discharges maintained by travelling waves: new plasma sources, discovered in 1974 and considered as a prototype of the gas discharges according to their definition as nonlinear systems which unify in a self-consistent manner plasmas and fields. In the presentation here of the fluid-plasma models of the diffusion-controlled regime of the travelling-wave-sustained discharges (TWSDs), the basic features of the discharge maintenance-the discharge self-consistency and the electron heating in the high-frequency field-are stressed. Operation of stationary and pulsed discharges, discharge maintenance without and in external magnetic fields as well as discharge production in different gases (argon, helium, helium-argon gas mixtures and hydrogen) are covered. Modulation instability of diffusion-controlled discharges and discharge filamentation at higher gas pressures are also included in the review. Experimental findings which motivate aspects of the reported modelling are pointed out

  17. Discharges from nuclear power stations

    International Nuclear Information System (INIS)

    1991-02-01

    HM Inspectorate of Pollution commissioned, with authorising responsibilities in England and Wales, a study into the discharges of radioactive effluents from Nuclear Power Stations. The study considered arisings from nuclear power stations in Europe and the USA and the technologies to treat and control the radioactive discharges. This report contains details of the technologies used at many nuclear power stations to treat and control radioactive discharges and gives, where information was available, details of discharges and authorised discharge limits. (author)

  18. Myelodysplastic Syndromes (MDS)

    Science.gov (United States)

    ... talk about donating their baby's cord blood College football player stays true to his commitment Be the ... appointment, the transplant doctor will: Review your medical history Talk with you about your treatment options Discuss ...

  19. Comparison of hollow cathode discharge plasma configurations

    International Nuclear Information System (INIS)

    Farnell, Casey C; Farnell, Cody C; Williams, John D

    2011-01-01

    Hollow cathodes used in plasma contactor and electric propulsion devices provide electrons for sustaining plasma discharges and enabling plasma bridge neutralization. Life tests show erosion on hollow cathodes exposed to the plasma environment produced in the region downstream of these devices. To explain the observed erosion, plasma flow field measurements are presented for hollow cathode generated plasmas using both directly immersed probes and remotely located plasma diagnostics. Measurements on two cathode discharge configurations are presented: (1) an open, no magnetic field configuration and (2) a setup simulating the discharge chamber environment of an ion thruster. In the open cathode configuration, large amplitude plasma potential oscillations, ranging from 20 to 85 V within a 34 V discharge, were observed using a fast response emissive probe. These oscillations were observed over a dc potential profile that included a well-defined potential hill structure. A remotely located electrostatic analyzer (ESA) was used to measure the energy of ions produced within the plasma, and energies were detected that met, and in some cases exceeded, the peak oscillatory plasma potentials detected by the emissive probe. In the ion thruster discharge chamber configuration, plasma potentials from the emissive probe again agreed with ion energies recorded by the remotely located ESA; however, much lower ion energies were detected compared with the open configuration. A simplified ion-transit model that uses temporal and spatial plasma property measurements is presented and used to predict far-field plasma streaming properties. Comparisons between the model and remote measurements are presented.

  20. Effect of 90-day space flight (MDS-ISS) on immunological parameters in mice: lymphocyte distribution and function

    Science.gov (United States)

    Roberts, Arthur; Lhuillier, Andrew; Liu, Yi; Ruggiu, Alessandra; Shi, Yufang

    Elucidation of the effects of space flight on the immune system of astronauts and other animal species is important for the survival and success of manned space flight, especially long-term missions. Space flight exposes astronauts to microgravity, galactic cosmic radiation (GCR), and various psycho-social stressors. Blood samples from astronauts returning from space flight have shown changes in the numbers and types of circulating leukocytes. Similarly, normal lym-phocyte homeostasis has been shown to be severely affected in mice using ground-based models of microgravity and GCR exposure, as demonstrated by profound effects on several immuno-logical parameters examined by other investigators and ourselves. In particular, lymphocyte numbers are significantly reduced and subpopulation distribution is altered in the spleen, thy-mus, and peripheral blood following hindlimb unloading (HU) in mice. Lymphocyte depletion was found to be mediated through corticosteroid-induced apoptosis, although the molecular mechanism of apoptosis induction is still under investigation. The proliferative capacity of TCR-stimulated lymphocytes was also inhibited after HU. We have similarly shown that mice exposed to high-energy 56Fe ion radiation have decreased lymphocyte numbers and perturba-tions in proportions of various subpopulations, including CD4+ and CD8+ T cells, and B cells in the spleen, and maturation stages of immature T cells in the thymus. To compare these ground-based results to the effects of actual space-flight, fresh spleen and thymus samples were recently obtained from normal and transgenic mice immediately after 90 d. space-flight in the MDS, and identically-housed ground control mice. Total leukocyte numbers in each organ were enumerated, and subpopulation distribution was examined by flow cytometric analysis of CD3, CD4, CD8, CD19, CD25, DX-5, and CD11b. Splenic T cells were stimulated with anti-CD3 and assessed for proliferation after 2-4 d., and production of

  1. Dendritic cells (DCs) can be successfully generated from leukemic blasts in individual patients with AML or MDS: an evaluation of different methods.

    Science.gov (United States)

    Kremser, Andreas; Dressig, Julia; Grabrucker, Christine; Liepert, Anja; Kroell, Tanja; Scholl, Nina; Schmid, Christoph; Tischer, Johanna; Kufner, Stefanie; Salih, Helmut; Kolb, Hans Jochem; Schmetzer, Helga

    2010-01-01

    Myeloid-leukemic cells (AML, MDS, CML) can be differentiated to leukemia-derived dendritic cell [DC (DCleu)] potentially presenting the whole leukemic antigen repertoire without knowledge of distinct leukemia antigens and are regarded as promising candidates for a vaccination strategy. We studied the capability of 6 serum-free DC culture methods, chosen according to different mechanisms, to induce DC differentiation in 137 cases of AML and 52 cases of MDS. DC-stimulating substances were cytokines ("standard-medium", "MCM-Mimic", "cytokine-method"), bacterial lysates ("Picibanil"), double-stranded RNA ["Poly (I:C)"] or a cytokine bypass method ("Ca-ionophore"). The quality/quantity of DC generated was estimated by flow cytometry studying (co) expressions of "DC"antigens, costimulatory, maturation, and blast-antigens. Comparing these methods on average 15% to 32% DC, depending on methods used, could be obtained from blast-containing mononuclear cells (MNC) in AML/MDS cases with a DC viability of more than 60%. In all, 39% to 64% of these DC were mature; 31% to 52% of leukemic blasts could be converted to DCleu and DCleu-proportions in the suspension were 2% to 70% (13%). Average results of all culture methods tested were comparable, however not every given case of AML could be differentiated to DC with 1 selected method. However performing a pre-analysis with 3 DC-generating methods (MCM-Mimic, Picibanil, Ca-ionophore) we could generate DC in any given case. Functional analyses provided proof, that DC primed T cells to antileukemia-directed cytotoxic cells, although an anti-leukemic reaction was not achieved in every case. In summary our data show that a successful, quantitative DC/DCleu generation is possible with the best of 3 previously tested methods in any given case. Reasons for different functional behaviors of DC-primed T cells must be evaluated to design a practicable DC-based vaccination strategy.

  2. The Impacts of Climate Change on the Discharge of Osse-Ossiomo ...

    African Journals Online (AJOL)

    There is a strong evidence of global warming using the index of temperature in the drainage basin. River discharge also indicated fluctuating trends from year to year in the decades with available discharge records. It was concluded that the river discharge pattern of Osse-Ossiomo River Basin, S. W. Nigeria exhibited ...

  3. Potential environmental benefits of improving recycling of polyolefines – LCA of Magnetic density separation (MDS) developed in the EU FP7 funded project W2Plastic

    DEFF Research Database (Denmark)

    Olsen, Stig Irving; Bonou, Alexandra

    2012-01-01

    identify eco-design criteria for the development and secondly to document the potential environmental improvement of polyolefin recycling using the MDS technology. A preliminary study focusing solely on the carbon footprint benefits of recycling plastic waste compared to virgin production of polymers...... showed that there are large benefits to recycling. However, including other uses of the waste illustrates that the benefits to a large extent depend on that the recycled plastic have such high quality that it can actually replace virgin plastic and also to some extent depends on which energy systems e.......g. energy recovery from incineration substitutes....

  4. Vessel Sewage Discharges: No-Discharge Zones (NDZs)

    Science.gov (United States)

    States may petition the EPA to establish areas, called no discharge zones (NDZs), where vessel sewage discharges are prohibited. This page describes how NDZs are designated, the types of designations, who enforces them, and how to comply.

  5. Underwater Ship Husbandry Discharges

    Science.gov (United States)

    2011-11-01

    which entered into force in September of 2008, prohibits the use of harmful organotins such as tributyltin ( TBT ) in AFCs used on international...States. The use of TBT AFCs is explicitly prohibited under the VGP, and vessels must remove such coatings or paint over them to prevent toxic ...to hull husbandry include (1) the discharge of toxic chemicals used as biocides in AFCs and (2) biofouling as a vector for aquatic nuisance species

  6. Radioactive wastes and discharges

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The guide sets out the radiation safety requirements and limits for the treatment of radioactive waste. They shall be observed when discharging radioactive substances into the atmosphere or sewer system, or when delivering solid, low-activity waste to a landfill site without a separate waste treatment plan. The guide does not apply to the radioactive waste resulting from the utilisation of nuclear energy or natural resources.

  7. Radioactive wastes and discharges

    International Nuclear Information System (INIS)

    2000-01-01

    The guide sets out the radiation safety requirements and limits for the treatment of radioactive waste. They shall be observed when discharging radioactive substances into the atmosphere or sewer system, or when delivering solid, low-activity waste to a landfill site without a separate waste treatment plan. The guide does not apply to the radioactive waste resulting from the utilisation of nuclear energy or natural resources

  8. An International MDS/MPN Working Group’s perspective and recommendations on molecular pathogenesis, diagnosis and clinical characterization of myelodysplastic/myeloproliferative neoplasms

    Science.gov (United States)

    Mughal, Tariq I.; Cross, Nicholas C.P.; Padron, Eric; Tiu, Ramon V.; Savona, Michael; Malcovati, Luca; Tibes, Raoul; Komrokji, Rami S.; Kiladjian, Jean-Jacques; Garcia-Manero, Guillermo; Orazi, Attilio; Mesa, Ruben; Maciejewski, Jaroslaw P.; Fenaux, Pierre; Itzykson, Raphael; Mufti, Ghulam; Solary, Eric; List, Alan F.

    2015-01-01

    In the 2008 WHO classification, chronic myeloid malignancies that share both myelodysplastic and myeloproliferative features define the myelodysplastic/myeloproliferative group, which includes chronic myelomonocytic leukemia, juvenile myelomonocytic leukemia, atypical chronic myeloid leukemia, refractory anemia with ring sideroblasts and thrombocytosis, and myelodysplastic/myeloproliferative unclassified. With the notable exception of refractory anemia with ring sideroblasts and thrombocytosis, there is much overlap among the various subtypes at the molecular and clinical levels, and a better definition of these entities, an understanding of their biology and an identification of subtype-specific molecular or cellular markers are needed. To address some of these challenges, a panel comprised of laboratory and clinical experts in myelodysplastic/myeloproliferative was established, and four independent academic MDS/MPN workshops were held on: 9th March 2013, in Miami, Florida, USA; 6th December 2013, in New Orleans, Louisiana, USA; 13th June 2014 in Milan, Italy; and 5th December 2014 in San Francisco, USA. During these meetings, the current understanding of these malignancies and matters of biology, diagnosis and management were discussed. This perspective and the recommendations on molecular pathogenesis, diagnosis and clinical characterization for adult onset myelodysplastic/myeloproliferative is the result of a collaborative project endorsed and supported by the MDS Foundation. PMID:26341525

  9. Plasma Discharge Process in a Pulsed Diaphragm Discharge System

    Science.gov (United States)

    Duan, Jianjin; Hu, Jue; Zhang, Chao; Wen, Yuanbin; Meng, Yuedong; Zhang, Chengxu

    2014-12-01

    As one of the most important steps in wastewater treatment, limited study on plasma discharge process is a key challenge in the development of plasma applications. In this study, we focus on the plasma discharge process of a pulsed diaphragm discharge system. According to the analysis, the pulsed diaphragm discharge proceeds in seven stages: (1) Joule heating and heat exchange stage; (2) nucleated site formation; (3) plasma generation (initiation of the breakdown stage); (4) avalanche growth and plasma expansion; (5) plasma contraction; (6) termination of the plasma discharge; and (7) heat exchange stage. From this analysis, a critical voltage criterion for breakdown is obtained. We anticipate this finding will provide guidance for a better application of plasma discharges, especially diaphragm plasma discharges.

  10. Aplicación del Escalamiento Multidimensional (MDS al análisis del discurso mediático. El caso de la cobertura periodística a los ‘escraches’

    Directory of Open Access Journals (Sweden)

    Xabier Albizu Landa

    2014-06-01

    Full Text Available En el presente artículo se discuten las posibilidades que ofrece la técnica de análisis multivariante conocida como Escalamiento Multidimensional (MDS para el análisis del discurso periodístico y la determinación de los frames presentes en este. En una primera parte se repasan las tradiciones de los análisis de framing y de la aplicación del MDS. En una segunda parte se presenta un caso práctico en el que el MDS es utilizado para la determinación de los frames presentes en la cobertura periodística a los escraches protagonizados en la primavera de 2013 por el movimiento contra los desahucios.

  11. Continuous pile discharging machine

    International Nuclear Information System (INIS)

    Smith, P.P.

    1976-01-01

    A device for discharging cartridges from tubes under fluid pressure includes a cylindrical housing adapted to be seated in a leak-tight manner on the end of one of the tubes, a chute depending from the cylindrical housing near the end seated on the end of the tube, a rotatable piston having a wrench on the forward end thereof disposed in the cylindrical housing and adapted to manipulate a plug in the end of the tube, and a telescopic hydraulic ram adapted to move the piston toward the plug. In addition the wrench contains a magnet which prevents inadvertent uncoupling of the wrench and the plug. 7 claims, 10 drawing figures

  12. Capacitive discharge exciplex lamps

    Energy Technology Data Exchange (ETDEWEB)

    Sosnin, E A; Erofeev, M V; Tarasenko, V F [High Current Electronics Institute, 2/3, Akademichesky Ave., Tomsk 634055 (Russian Federation)

    2005-09-07

    Simple-geometry exciplex lamps of a novel type excited by a capacitive discharge (CD-excilamps) have been investigated. An efficient radiation has been obtained on KrBr*, KrCl*, XeBr*, XeCl* molecules and I* atom. The highest values of efficiency of various working molecules are approximately 10-18%. The lifetime of the operating gas mixture in KrCl*, XeCl*, I* and XeBr* exciplex lamps excited by a CD is above 1000 h. Owing to the above-mentioned characteristics, the exciplex lamps excited by a CD are supposed to be very promising for various applications.

  13. Capacitive discharge exciplex lamps

    International Nuclear Information System (INIS)

    Sosnin, E A; Erofeev, M V; Tarasenko, V F

    2005-01-01

    Simple-geometry exciplex lamps of a novel type excited by a capacitive discharge (CD-excilamps) have been investigated. An efficient radiation has been obtained on KrBr*, KrCl*, XeBr*, XeCl* molecules and I* atom. The highest values of efficiency of various working molecules are approximately 10-18%. The lifetime of the operating gas mixture in KrCl*, XeCl*, I* and XeBr* exciplex lamps excited by a CD is above 1000 h. Owing to the above-mentioned characteristics, the exciplex lamps excited by a CD are supposed to be very promising for various applications

  14. Continuous pile discharging machine

    Science.gov (United States)

    Smith, Phillips P.

    1976-05-11

    A device for discharging cartridges from tubes under fluid pressure includes a cylindrical housing adapted to be seated in a leak-tight manner on the end of one of the tubes, a chute depending from the cylindrical housing near the end seated on the end of the tube, a rotatable piston having a wrench on the forward end thereof disposed in the cylindrical housing and adapted to manipulate a plug in the end of the tube, and a telescopic hydraulic ram adapted to move the piston toward the plug. In addition the wrench contains a magnet which prevents inadvertent uncoupling of the wrench and the plug.

  15. Discharge reductions-value for money?

    International Nuclear Information System (INIS)

    Morley, R G; Coates, R; Taylor, R H

    2004-01-01

    Through the Nuclear Liabilities Management Authority White Paper, the UK Government and the Regulators have signalled a commitment to further improving the operation of the regulatory regime and to its operating within the principles of proportionality, transparency, consistency and accountability which underpin the Government's approach to regulation in general. Particular emphasis is placed upon ensuring that there is greater consistency in the treatment of risk and hazard; proportionate and cost effective delivery of public, worker and environmental protection; and an open and transparently applied regulatory system. The paper uses the historical record of radioactive discharges from BNFL's Sellafield reprocessing site in the UK and seeks to identify what have been the key drivers for change, particularly over the past 20 years of significant discharge reductions. The paper examines the current context for ongoing and future discharges from the site, and the incorporation of the use of the concepts of best practicable environmental option and best practicable means. Intergovernmental commitments such as the OSPAR Sintra and Bremen statements and the developing UK policy framework are also considered, together with BNFL's work with a wide range of 'green' stakeholders. The paper outlines the principal components of BNFL's decision-making processes for discharge control and abatement; and how these interact with the relevant external pressures. It then analyses whether the overall drivers and outcomes align with the declared desire of the UK Government to ensure that the taxpayer receives value for money in the new national arrangements for managing historic nuclear liabilities

  16. Cryogenic high current discharges

    International Nuclear Information System (INIS)

    Meierovich, B.E.

    1994-01-01

    Z-pinches formed from frozen deuterium fibers by a rapidly rising current have enhanced stability and high neutron yield. The efforts to understand the enhanced stability and neutron yield on the basis of classical picture of Bennett equilibrium of the current channel has not given satisfactory results. The traditional approach does not take into account the essential difference between the frozen deuterium fiber Z-pinches and the usual Z-pinches such as exploding wires or classical gas-puffed Z-pinches. The very low temperature of the fiber atoms (10 K), together with the rapidly rising current, result in the coexistence of a high current channel with unionized fiber atoms for a substantial period of time. This phenomena lasts during the risetime. This approach takes into account the difference of the breakdown in a dielectric deuterium fiber and the breakdown in a metallic wire. This difference is essential to the understanding of specific features of cryogenic high current discharges. Z-pinches in frozen deuterium fibers should be considered as a qualitatively new phenomenon on the boundary of cryogenic and high current physics. It is a start of a new branch in plasma physics: the physics of cryogenic high current discharges

  17. Quality of life, physical function and MRI T2* in elderly low-risk MDS patients treated to a haemoglobin level of ≥120 g/L with darbepoetin alfa ± filgrastim or erythrocyte transfusions

    DEFF Research Database (Denmark)

    Nilsson-Ehle, Herman; Birgegård, Gunnar; Samuelsson, Jan

    2011-01-01

    Anaemia in low-risk myelodysplastic syndromes (MDS) is associated with reduced quality of life (QoL). Response to treatment with erythropoietin ± granulocyte colony-stimulating factor (G-CSF) is associated with improved QoL, but whether transfusion therapy with higher haemoglobin (Hb) target levels...... has similar effects is unknown. The objective for this prospective phase II Nordic multicentre trial was to assess QoL, response rate and physical function in elderly anaemic MDS patients treated to a target Hb level of >120 g/L....

  18. Modified PADSS (Post Anaesthetic Discharge Scoring System) for monitoring outpatients discharge.

    Science.gov (United States)

    Palumbo, Piergaspare; Tellan, Guglielmo; Perotti, Bruno; Pacilè, Maria Antonietta; Vietri, Francesco; Illuminati, Giulio

    2013-01-01

    The decision to discharge a patient undergoing day surgery is a major step in the hospitalization pathway, because it must be achieved without compromising the quality of care, thus ensuring the same assistance and wellbeing as for a long-term stay. Therefore, the use of an objective assessment for the management of a fair and safe discharge is essential. The authors propose the Post Anaesthetic Discharge Scoring System (PADSS), which considers six criteria: vital signs, ambulation, nausea/vomiting, pain, bleeding and voiding. Each criterion is given a score ranging from 0 to 2. Only patients who achieve a score of 9 or more are considered ready for discharge. Furthermore, PADSS has been modified to ensure a higher level of safety, thus the "vital signs" criteria must never score lower than 2, and none of the other five criteria must ever be equal to 0, even if the total score reaches 9. The effectiveness of PADSS was analyzed on 2432 patients, by recording the incidence of postoperative complications and the readmission to hospital. So far PADDS has proved to be an efficient system that guarantees safe discharge.

  19. Diffusion of condenser water discharge

    International Nuclear Information System (INIS)

    Iwakiri, Toshio

    1977-01-01

    Thermal and nuclear power stations in Japan are mostly located in coastal area, and the cooling water is discharged into sea as warm water. Recently, large interest is taken in this matter, and it is desirable to predict the diffusion of warm discharge accurately and to take effective measures for lowering the temperature. As for the methods of predicting the diffusion of warm discharge, simplified estimation, mathematical analysis and hydrographical model experiment are used corresponding to objects and conditions. As for the measures to lower temperature, the method of discharging warm water into deep sea bottom was confirmed to be very effective. In this paper, the phenomena of diffusion of warm discharge in sea, the methods of predicting the diffusion of warm discharge, and the deep sea discharge as the measure for lowering temperature are outlined. The factors concerning the diffusion of warm discharge in sea are the conditions of discharge, topography and sea state, and the diffusion is roughly divided into mixing diffusion in the vicinity of warm water outlet and eddy diffusion in distant region. It is difficult to change artificially the conditions of diffusion in distant region, and the measures of raising the rate of dilution in near region are effective, therefore the deep sea discharge is adopted. (Kako, I.)

  20. To change or not to change - translating and culturally adapting the paediatric version of the Moral Distress Scale-Revised (MDS-R).

    Science.gov (United States)

    Af Sandeberg, Margareta; Wenemark, Marika; Bartholdson, Cecilia; Lützén, Kim; Pergert, Pernilla

    2017-02-20

    Paediatric cancer care poses ethically difficult situations that can lead to value conflicts about what is best for the child, possibly resulting in moral distress. Research on moral distress is lacking in paediatric cancer care in Sweden and most questionnaires are developed in English. The Moral Distress Scale-Revised (MDS-R) is a questionnaire that measures moral distress in specific situations; respondents are asked to indicate both the frequency and the level of disturbance when the situation arises. The aims of this study were to translate and culturally adapt the questionnaire to the context of Swedish paediatric cancer care. In doing so we endeavoured to keep the content in the Swedish version as equivalent to the original as possible but to introduce modifications that improve the functional level and increase respondent satisfaction. The procedure included linguistic translation and cultural adaptation of MDS-R's paediatric versions for Physicians, Nurses and Other Healthcare Providers to the context of Swedish paediatric cancer care. The process of adjustment included: preparation, translation procedure and respondent validation. The latter included focus group and cognitive interviews with healthcare professionals in paediatric cancer care. To achieve a Swedish version with a good functional level and high trustworthiness, some adjustments were made concerning design, language, cultural matters and content. Cognitive interviews revealed problems with stating the level of disturbance hypothetically and items with negations caused even more problems, after having stated that the situation never happens. Translation and cultural adaptation require the involvement of various types of specialist. It is difficult to combine the intention to keep the content as equivalent to the original as possible with the need for modifications that improve the functional level and increase respondent satisfaction. The translated and culturally adapted Swedish MDS-R seems

  1. Azacitidine-lenalidomide (ViLen) combination yields a high response rate in higher risk myelodysplastic syndromes (MDS)-ViLen-01 protocol.

    Science.gov (United States)

    Mittelman, Moshe; Filanovsky, Kalman; Ofran, Yishai; Rosenbaum, Hanna; Raanani, Pia; Braester, Andrei; Goldschmidt, Neta; Kirgner, Ilya; Herishanu, Yair; Perri, Chava; Ellis, Martin; Oster, Howard S

    2016-10-01

    Azacitidine treatment is effective in higher risk MDS (HR-MDS), with less than 50 % response, lasting 2 years. Aza and lenalidomide (Len) have a potential synergistic effect. ViLen-01 phase IIa trial includes 6-month induction (Aza 75 mg/m(2)/day, days 1-5, Len 10 mg/day, days 6-21, every 28 days), 6-month consolidation (Aza 75 mg/m(2)/day, days 1-5, every 28 days), and 12-month maintenance (Len 10 mg/day, days 1-21, every 28 days). Response was evaluated according to IWG criteria. Totally, 25 patients enrolled, with an average of 76.3 years old (60-87), and 88 % with major comorbidities. Thirteen patients completed induction, 7 proceeded for consolidation, and 2 for maintenance. The overall response rate (ORR) was 72 % (18/25), with 6 (24 %) for CR, 3 (12 %) for marrow CR, and 9 (36 %) for hematologic improvement (HI). The 7 non-responding patients were on the study 3 days to 4.1 months. At 6 months, 4 of 6 evaluable patients achieved complete cytogenetic response and 2 with del (5q) at diagnosis. Adverse events (AEs) were as expected in these patients: grades III-IV, mainly hematologic-thrombocytopenia (20 patients) and neutropenia (13 patients). The common non-hematologic AEs were infections (14 patients), nausea (7), vomiting (7), diarrhea (7), and skin reactions (5). The median progression-free survival (PFS) was 12 ± 1.36 months, with median overall survival (OS) of 12 ± 1.7 months. Quality of life (FACT questionnaire) data were available for 12 patients with a tendency towards improved QoL. This trial with elderly HR-MDS patients with an expected poor prognosis demonstrates a high (72 %) response rate and a reasonable expected safety profile but a relatively short PFS and OS.

  2. Heart bypass surgery - minimally invasive - discharge

    Science.gov (United States)

    ... invasive direct coronary artery bypass - discharge; MIDCAB - discharge; Robot assisted coronary artery bypass - discharge; RACAB - discharge; Keyhole ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  3. Vaginal Discharge: What's Normal, What's Not

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Vaginal Discharge: What's Normal, What's Not KidsHealth / For Teens / ... Discharge: What's Normal, What's Not Print What Is Vaginal Discharge? Vaginal discharge is fluid that comes from ...

  4. Assessing the Effects of Climate on Global Fluvial Discharge Variability

    Science.gov (United States)

    Hansford, M. R.; Plink-Bjorklund, P.

    2017-12-01

    Plink-Bjorklund (2015) established the link between precipitation seasonality and river discharge variability in the monsoon domain and subtropical rivers (see also Leier et al, 2005; Fielding et al., 2009), resulting in distinct morphodynamic processes and a sedimentary record distinct from perennial precipitation zone in tropical rainforest zone and mid latitudes. This study further develops our understanding of discharge variability using a modern global river database created with data from the Global Runoff Data Centre (GRDC). The database consists of daily discharge for 595 river stations and examines them using a series of discharge variability indexes (DVI) on different temporal scales to examine how discharge variability occurs in river systems around the globe. These indexes examine discharge of individual days and monthly averages that allows for comparison of river systems against each other, regardless of size of the river. Comparing river discharge patterns in seven climate zones (arid, cold, humid subtropics, monsoonal, polar, rainforest, and temperate) based off the Koppen-Geiger climate classifications reveals a first order climatic control on discharge patterns and correspondingly sediment transport. Four groupings of discharge patterns emerge when coming climate zones and DVI: persistent, moderate, seasonal, and erratic. This dataset has incredible predictive power about the nature of discharge in fluvial systems around the world. These seasonal effects on surface water supply affects river morphodynamics and sedimentation on a wide timeframe, ranging from large single events to an inter-annual or even decadal timeframe. The resulting sedimentary deposits lead to differences in fluvial architecture on a range of depositional scales from sedimentary structures and bedforms to channel complex systems. These differences are important to accurately model for several reasons, ranging from stratigraphic and paleoenviromental reconstructions to more

  5. Analysis of Multipactor Discharge

    International Nuclear Information System (INIS)

    Lau, Y. Y.

    2005-01-01

    Several comprehensive studies of radio frequency (rf) breakdown and rf heating are reported. They are of general interest to magnetic confinement fusion, rf linac, and high power microwave source development. The major results include: (1) a ground-breaking theory of multipactor discharge on dielectric, including a successful proof-of-principle experiment that verified the newly developed scaling laws, (2) an in depth investigation of the failure mechanisms of diamond windows and ceramic windows, and of the roles of graphitization, thin films of coating and contaminants, and (3) a most comprehensive theory, to date, on the heating of particulates by an electromagnetic pulse, and on the roles of rf magnetic field heating and of rf electric field heating, including the construction of new scaling laws that govern them. The above form a valuable knowledge base for the general problem of heating phenomenology

  6. Radioactive wastes and discharges

    International Nuclear Information System (INIS)

    1993-01-01

    According to the Section 24 of the Finnish Radiation Decree (1512/91), the Finnish Centre for Radiation and Nuclear Safety shall specify the concentration and activity limits and principles for the determination whether a waste can be defined as a radioactive waste or not. The radiation safety requirements and limits for the disposal of radioactive waste are given in the guide. They must be observed when discharging radioactive waste into the atmosphere or sewer system, or when delivering solid low-activity waste to a landfill site without a separate waste disposal plan. The guide does not apply to the radioactive waste resulting from the utilization of nuclear energy of natural resources. (4 refs., 1 tab.)

  7. Phenological Records

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Phenology is the scientific study of periodic biological phenomena, such as flowering, breeding, and migration, in relation to climatic conditions. The few records...

  8. Dicarboxylic acids from electric discharge

    Science.gov (United States)

    Zeitman, B.; Chang, S.; Lawless, J. G.

    1974-01-01

    An investigation was conducted concerning the possible synthesis of a suite of dicarboxylic acids similar to that found in the Murchison meteorite. The investigation included the conduction of a chemical evolution experiment which simulated electric discharge through the primitive atmosphere of the earth. The suite of dicarboxylic acids obtained in the electric discharge experiment is similar to that of the Murchison meteorite, except for the fact that 2-chlorosuccinic acid is present in the spark discharge.

  9. Short-term variability of Johor River discharge based on wavelet analysis

    Science.gov (United States)

    Ahmad, N.; Kamaruddin, S. A.; Heryansyah, A.

    2015-02-01

    River discharge provides a direct measure of water quantity and availability of water for specific uses. It also provides the basis for understanding river basin processes and is essential for interpreting and understanding river flow characteristics. This study investigates the temporal variability of river discharge records of Johor River. Wavelet analysis of discharge records for 30 years was carried out to characterize the river flow variability. Our results indicate that Johor River discharge data shows a significant short-term variability of between 0.6 to 2.5 years.

  10. Discharge cleaning for a tokamak

    International Nuclear Information System (INIS)

    Ishii, Shigeyuki

    1983-01-01

    Various methods of discharge cleaning for tokamaks are described. The material of the first walls of tokamaks is usually stainless steel, inconel, titanium and so on. Hydrogen is exclusively used as the discharge gas. Glow discharge cleaning (GDC), Taylor discharge cleaning (TDC), and electron cyclotron resonance discharge cleaning (ECR-DC) are discussed in this paper. The cleaning by GDC is made by moving a movable anode to the center of a tokamak vassel. Taylor found the good cleaning effect of induced discharge by high pressure and low power discharge. This is called TDC. When the frequency of high frequency discharge in a magnetic field is equal to that of the electron cyclotron resonance, the break down potential is lowered if the pressure is sufficiently low. The ECR-CD is made by using this effect. In TDC and ECR-DC, the electron temperature, which has a close relation to the production rate of H 0 , can be controlled by the pressure. In GDC, the operating pressure was improved by the radio frequency glow (RG) method. However, there is still the danger of arcing. In case of GDC and ECR-DC, the position of plasma can be controlled, but not in case of TDC. The TDC is accepted by most of takamak devices in the world. (Kato, T.)

  11. The practice of terminal discharge.

    Science.gov (United States)

    Radha Krishna, Lalit Kumar; Murugam, Vengadasalam; Quah, Daniel Song Chiek

    2017-01-01

    'Terminal discharges' are carried out in Singapore for patients who wish to die at home. However, if due diligence is not exercised, parallels may be drawn with euthanasia. We present a theoretical discussion beginning with the definition of terminal discharges and the reasons why they are carried out in Singapore. By considering the intention behind terminal discharges and utilising a multidisciplinary team to deliberate on the clinical, social and ethical intricacies with a patient- and context-specific approach, euthanasia is avoided. It is hoped that this will provide a platform for professionals in palliative medicine to negotiate challenging issues when arranging a terminal discharge, so as to avoid the pitfall of committing euthanasia in a country such as Singapore where euthanasia is illegal. It is hoped that a set of guidelines for terminal discharges may someday be realised to assist professionals in Singapore and around the world.

  12. The ASDEX Upgrade discharge schedule

    International Nuclear Information System (INIS)

    Neu, G.; Engelhardt, K.; Raupp, G.; Treutterer, W.; Zasche, D.; Zehetbauer, T.

    2007-01-01

    ASDEX Upgrade's recently commissioned discharge control system (DCS) marks the transition from a traditional programmed system to a highly flexible 'data driven' one. The allocation of application processes (APs) to controllers, the interconnection of APs through uniquely named signals, and AP control parameter values are all defined as data, and can easily be adapted to the requirements of a particular discharge. The data is laid down in a set of XML documents which APs request via HTTP from a configuration server before a discharge. The use of XML allows for easy parsing, and structural validation through (XSD) schemas. The central input to the configuration process is the discharge schedule (DS), which embodies the dynamic behaviour of a planned discharge as reference trajectories grouped in segments, concatenated through transition conditions. Editing, generation and validation tools, and version control through CVS allow for efficient management of DSs

  13. High performance experiments in JT-60U reversed shear discharges

    International Nuclear Information System (INIS)

    Fujita, T.; Kamada, Y.; Ishida, S.

    2001-01-01

    The operation of JT-60U reversed shear discharges has been extended to a high plasma current, low-q regime keeping a large radius of the internal transport barrier (ITB) and the record value of equivalent fusion multiplication factor in JT-60U, Q DT eq =1.25, has been achieved at 2.6 MA. Operational schemes to reach the low-q regime with good reproducibility have been developed. The reduction of Z eff was obtained in the newly installed W-shaped pumped divertor. The beta limit in the low-q min regime, which limited the performance of L-mode edge discharges, has been improved in H-mode edge discharges with a broader pressure profile, which was obtained by power flow control with ITB degradation. Sustainment of ITB and improved confinement for 5.5 seconds has been demonstrated in an ELMy H reversed shear discharge. (author)

  14. Midcervical neuronal discharge patterns during and following hypoxia

    Science.gov (United States)

    Sandhu, M. S.; Baekey, D. M.; Maling, N. G.; Sanchez, J. C.; Reier, P. J.

    2014-01-01

    Anatomical evidence indicates that midcervical interneurons can be synaptically coupled with phrenic motoneurons. Accordingly, we hypothesized that interneurons in the C3–C4 spinal cord can display discharge patterns temporally linked with inspiratory phrenic motor output. Anesthetized adult rats were studied before, during, and after a 4-min bout of moderate hypoxia. Neuronal discharge in C3–C4 lamina I–IX was monitored using a multielectrode array while phrenic nerve activity was extracellularly recorded. For the majority of cells, spike-triggered averaging (STA) of ipsilateral inspiratory phrenic nerve activity based on neuronal discharge provided no evidence of discharge synchrony. However, a distinct STA phrenic peak with a 6.83 ± 1.1 ms lag was present for 5% of neurons, a result that indicates a monosynaptic connection with phrenic motoneurons. The majority (93%) of neurons changed discharge rate during hypoxia, and the diverse responses included both increased and decreased firing. Hypoxia did not change the incidence of STA peaks in the phrenic nerve signal. Following hypoxia, 40% of neurons continued to discharge at rates above prehypoxia values (i.e., short-term potentiation, STP), and cells with initially low discharge rates were more likely to show STP (P phrenic motoneuron pool, and these cells can modulate inspiratory phrenic output. In addition, the C3–C4 propriospinal network shows a robust and complex pattern of activation both during and following an acute bout of hypoxia. PMID:25552641

  15. RECORDS REACHING RECORDING DATA TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    G. W. L. Gresik

    2013-07-01

    Full Text Available The goal of RECORDS (Reaching Recording Data Technologies is the digital capturing of buildings and cultural heritage objects in hard-to-reach areas and the combination of data. It is achieved by using a modified crane from film industry, which is able to carry different measuring systems. The low-vibration measurement should be guaranteed by a gyroscopic controlled advice that has been , developed for the project. The data were achieved by using digital photography, UV-fluorescence photography, infrared reflectography, infrared thermography and shearography. Also a terrestrial 3D laser scanner and a light stripe topography scanner have been used The combination of the recorded data should ensure a complementary analysis of monuments and buildings.

  16. Records Reaching Recording Data Technologies

    Science.gov (United States)

    Gresik, G. W. L.; Siebe, S.; Drewello, R.

    2013-07-01

    The goal of RECORDS (Reaching Recording Data Technologies) is the digital capturing of buildings and cultural heritage objects in hard-to-reach areas and the combination of data. It is achieved by using a modified crane from film industry, which is able to carry different measuring systems. The low-vibration measurement should be guaranteed by a gyroscopic controlled advice that has been , developed for the project. The data were achieved by using digital photography, UV-fluorescence photography, infrared reflectography, infrared thermography and shearography. Also a terrestrial 3D laser scanner and a light stripe topography scanner have been used The combination of the recorded data should ensure a complementary analysis of monuments and buildings.

  17. Lightning discharges produced by wind turbines

    Science.gov (United States)

    Montanyà, Joan; van der Velde, Oscar; Williams, Earle R.

    2014-02-01

    New observations with a 3-D Lightning Mapping Array and high-speed video are presented and discussed. The first set of observations shows that under certain thunderstorm conditions, wind turbine blades can produce electric discharges at regular intervals of 3 s in relation to its rotation, over periods of time that range from a few minutes up to hours. This periodic effect has not been observed in static towers indicating that the effect of rotation is playing a critical role. The repeated discharges can occur tens of kilometers away from electrically active thunderstorm areas and may or may not precede a fully developed upward lightning discharge from the turbine. Similar to rockets used for triggering lightning, the fast movement of the blade tip plays an important role on the initiation of the discharge. The movement of the rotor blades allows the tip to "runaway" from the generated corona charge. The second observation is an uncommon upward/downward flash triggered by a wind turbine. In that flash, a negative upward leader was initiated from a wind turbine without preceding lightning activity. The flash produced a negative cloud-to-ground stroke several kilometers from the initiation point. The third observation corresponds to a high-speed video record showing simultaneous upward positive leaders from a group of wind turbines triggered by a preceding intracloud flash. The fact that multiple leaders develop simultaneously indicates a poor shielding effect among them. All these observations provide some special features on the initiation of lightning by nonstatic and complex tall structures.

  18. 25 CFR 38.9 - Discharge of educators.

    Science.gov (United States)

    2010-04-01

    ... any uniform procedure as it may adopt, may issue a formal written certification to the school... than cause during the school term. The individual's personnel record will clearly reflect that the... steps to be followed by school supervisors, ASE's, and AEPA's in discharge for cause cases. These...

  19. History of Discharge of Radionuclide from Nuclear Malaysia Research Reactor

    International Nuclear Information System (INIS)

    Mohd Nahar Othman; Ismail Sulaiman

    2013-01-01

    After more than 40 years the operation of Malaysian Nuclear Agency research reactor, this is the first time, the discharge emission radionuclide to environment is recorded and analyzed in detail. Starting from 1984, radionuclide Ar-41 had been analyzed manually by Research Officers but their finding is not recorded in any Journal. That is responsible of Safety and Health Division to make sure the safety of the workers and public living around Malaysian Nuclear Agency receive safe dose. This paper will report dose that had been discharge to the environment starting from 1984 to 2012 and it detail calculations.After more than 40 years the operation of Malaysian Nuclear Agency research reactor, this is the first time, the discharge emission radionuclide to environment is recorded and analyzed in detail. Starting from 1984, radionuclide Ar-41 had been analyzed manually by Research Officers but their finding is not recorded in any Journal. That is responsible of Safety and Health Division to make sure the safety of the workers and public living around Malaysian Nuclear Agency receive safe dose. This paper will report dose that had been discharge to the environment starting from 1984 to 2012 and it detail calculations. (author)

  20. Communication at the interface between hospitals and primary care - a general practice audit of hospital discharge summaries.

    Science.gov (United States)

    Belleli, Esther; Naccarella, Lucio; Pirotta, Marie

    2013-12-01

    Timeliness and quality of hospital discharge summaries are crucial for patient safety and efficient health service provision after discharge. We audited receipt rates, timeliness and the quality of discharge summaries for 49 admissions among 38 patients in an urban general practice. For missing discharge summaries, a hospital medical record search was performed. Discharge summaries were received for 92% of identified admissions; 73% were received within three days and 55% before the first post-discharge visit to the general practitioner (GP). Administrative information and clinical content, including diagnosis, treatment and follow-up plans, were well reported. However, information regarding tests, referrals and discharge medication was often missing; 57% of summaries were entirely typed and 13% had legibility issues. Completion rates were good but utility was compromised by delays, content omissions and formatting. Digital searching enables extraction of information from rich existing datasets contained in GP records for accurate measurement of discharge summary receipt rate and timing.

  1. Discharge Planning in Chronic Conditions

    Science.gov (United States)

    McMartin, K

    2013-01-01

    Background Chronically ill people experience frequent changes in health status accompanied by multiple transitions between care settings and care providers. Discharge planning provides support services, follow-up activities, and other interventions that span pre-hospital discharge to post-hospital settings. Objective To determine if discharge planning is effective at reducing health resource utilization and improving patient outcomes compared with standard care alone. Data Sources A standard systematic literature search was conducted for studies published from January 1, 2004, until December 13, 2011. Review Methods Reports, randomized controlled trials, systematic reviews, and meta-analyses with 1 month or more of follow-up and limited to specified chronic conditions were examined. Outcomes included mortality/survival, readmissions and emergency department (ED) visits, hospital length of stay (LOS), health-related quality of life (HRQOL), and patient satisfaction. Results One meta-analysis compared individualized discharge planning to usual care and found a significant reduction in readmissions favouring individualized discharge planning. A second meta-analysis compared comprehensive discharge planning with postdischarge support to usual care. There was a significant reduction in readmissions favouring discharge planning with postdischarge support. However, there was significant statistical heterogeneity. For both meta-analyses there was a nonsignificant reduction in mortality between the study arms. Limitations There was difficulty in distinguishing the relative contribution of each element within the terms “discharge planning” and “postdischarge support.” For most studies, “usual care” was not explicitly described. Conclusions Compared with usual care, there was moderate quality evidence that individualized discharge planning is more effective at reducing readmissions or hospital LOS but not mortality, and very low quality evidence that it is more

  2. Regression models of discharge and mean velocity associated with near-median streamflow conditions in Texas: utility of the U.S. Geological Survey discharge measurement database

    Science.gov (United States)

    Asquith, William H.

    2014-01-01

    A database containing more than 16,300 discharge values and ancillary hydraulic attributes was assembled from summaries of discharge measurement records for 391 USGS streamflow-gauging stations (streamgauges) in Texas. Each discharge is between the 40th- and 60th-percentile daily mean streamflow as determined by period-of-record, streamgauge-specific, flow-duration curves. Each discharge therefore is assumed to represent a discharge measurement made for near-median streamflow conditions, and such conditions are conceptualized as representative of midrange to baseflow conditions in much of the state. The hydraulic attributes of each discharge measurement included concomitant cross-section flow area, water-surface top width, and reported mean velocity. Two regression equations are presented: (1) an expression for discharge and (2) an expression for mean velocity, both as functions of selected hydraulic attributes and watershed characteristics. Specifically, the discharge equation uses cross-sectional area, water-surface top width, contributing drainage area of the watershed, and mean annual precipitation of the location; the equation has an adjusted R-squared of approximately 0.95 and residual standard error of approximately 0.23 base-10 logarithm (cubic meters per second). The mean velocity equation uses discharge, water-surface top width, contributing drainage area, and mean annual precipitation; the equation has an adjusted R-squared of approximately 0.50 and residual standard error of approximately 0.087 third root (meters per second). Residual plots from both equations indicate that reliable estimates of discharge and mean velocity at ungauged stream sites are possible. Further, the relation between contributing drainage area and main-channel slope (a measure of whole-watershed slope) is depicted to aid analyst judgment of equation applicability for ungauged sites. Example applications and computations are provided and discussed within a real-world, discharge

  3. Recurrent vaginal discharge in children.

    Science.gov (United States)

    McGreal, Sharon; Wood, Paul

    2013-08-01

    Childhood vaginal discharge remains a frequent reason for referral from primary to secondary care. The Pediatric and Adolescent Gynecology (PAG) service at Kettering General Hospital was established in 1993 and provides a specialized service that meets the needs of children with gynaecological conditions. To investigate recurrent vaginal discharge noting symptomatology, defining pathogens, common and rarer causes, exploring management regimes, and any changes in practice over time. Retrospective review spanning 15 years identifying prepubertal children attending the outpatient PAG clinic with recurrent vaginal discharge. We reviewed the medical notes individually. 110 patients were identified; 85% were referred from primary care. The age distribution was bimodal at four and eight years. Thirty-five percent of our patients were discharged after the initial consultation. The commonest cause of discharge was vulvovaginitis (82%). Other important causes included suspected sexual abuse (5%), foreign body (3%), labial adhesions (3%), vaginal agenesis (2%). 35% of patients were admitted for vaginoscopy. Vaginal discharge is the most common gynecological symptom in prepubertal girls and can cause repeated clinical episodes. Vulvovaginitis is the most common cause and often responds to simple hygiene measures. Awareness of the less common causes of vaginal discharge is essential. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  4. Legal aspects of thermal discharges

    International Nuclear Information System (INIS)

    Martin, A.J.

    1974-01-01

    An overview of those legal areas which directly affect technical and planning decisions is presented in the form of 2 legal approaches which constrain the indiscriminate release of thermal discharges to receiving waters. One takes the form of private remedies which have traditionally been available to aggrieved parties who are in some way damaged by the harmful discharge. The 2nd approach utilizes the various statutory constraints leading to direct governmental action. It appears that statutory law is playing the prominent role in restricting the temperature to which receiving waters may be raised as a result of such discharges by using effluent limitations and water quality standards. (Water Resour. Abstr.)

  5. An introduction to gas discharges

    CERN Document Server

    Howatson, A M

    2013-01-01

    An Introduction to Gas Discharges: Second Edition aims to provide a compact introduction to the subject of gas discharges, which continues to make both scientific and industrial progress. In this second edition, the author has made minor corrections, rewritten and expanded some sections, used SI units and modernized notions, in hopes of making the book more up to date. Included in the book is a short history of the subject, an introduction that enumerates the types of gas discharges, the fundamental processes, and then moves on to the more specific areas such as the breakdown, the self-sustai

  6. CQI project improves discharge process.

    Science.gov (United States)

    1998-08-01

    At Gibson Rehab Center in Williamsport, PA, a continuous quality improvement project to bolster the institution's discharge planning process has resulted in increased satisfaction and an award for quality. The 15-month project was spearheaded by a multidisciplinary team charged with identifying areas that had a significant impact on customer service and suggesting better ways of delivering that service. Among the changes the group suggested were establishing a weekly discharge planning group for new neuro patients, assigning a discharge coordinator for each treatment team, and creating an interdisciplinary communication sheet for the home health therapy staff.

  7. Clinical Impact of Epileptiform Discharge in Children With Attention-Deficit/Hyperactivity Disorder (ADHD).

    Science.gov (United States)

    Lee, Eun Hye; Choi, Yong Sung; Yoon, Hoi Soo; Bahn, Geon Ho

    2016-04-01

    The aim of this study was to investigate the prevalence and clinical significance of epileptiform discharges in patients with attention-deficit/hyperactivity disorder (ADHD). The authors retrospectively reviewed 180 children who were diagnosed with ADHD and had an electroencephalography (EEG) recording. Epileptiform discharges were found in 29 (16.1%) of 180 patients with ADHD. Of these, 15 (8.3%) had generalized epileptiform discharges and 14 (7.7%) had focal epileptiform discharges. The focal epileptiform discharges were most prevalent from the frontal (5/14) and rolandic area (5/14). Among the 29 patients with epileptiform discharges and ADHD, 5 patients had previous history of epilepsy and 4 patients developed epilepsy later, whereas none of the normal EEG group developed epilepsy. The authors suggest that interictal epileptiform discharges appear to be associated with seizure occurrence in children with ADHD and might reflect maturational pathophysiology overlapping with epilepsy. © The Author(s) 2015.

  8. Variations in tropical cyclone-related discharge in four watersheds near Houston, Texas

    Directory of Open Access Journals (Sweden)

    Laiyin Zhu

    2015-01-01

    Full Text Available We examined a 60-year record of daily precipitation and river discharge related to tropical cyclones (TCs in four watersheds undergoing land use and land cover change near Houston, Texas. Results show that TCs are responsible for ∼20% of the annual maximum discharge events in the four selected watersheds. Although there are no trends in TC precipitation, increasing trends were observed in daily extreme discharge and TC-related discharge. The more developed watersheds (Whiteoak Bayou and Brays Bayou, tend to have higher extreme discharge and steeper trends in extreme discharge than the less developed watersheds (Cypress Creek. Increases in TC-related extreme discharges correspond with increases in developed land and decreases in vegetated land between 1980 and 2006. Therefore, changes in land cover/use in watersheds near Houston are a major cause of the increased flooding risk in recent years.

  9. Vaginal itching and discharge - child

    Science.gov (United States)

    Pruritus vulvae; Itching - vaginal area; Vulvar itching; Yeast infection - child ... Common causes of vaginal itching and discharge in young girls include: Chemicals such as perfumes and dyes in detergents, fabric softeners, creams, ointments, ...

  10. Microwave discharges in capillary tubes

    International Nuclear Information System (INIS)

    Dervisevic, Emil

    1984-01-01

    This research thesis aims at being a contribution to the study of microwave discharge by a surface wave, and more precisely focusses on the discharge in capillary tubes filled with argon. The author first present theoretical models which describe, on the one hand, the propagation of the surface wave along the plasma column, and, on the other hand, longitudinal and radial profiles of the main discharge characteristics. The second part addresses the study of the influence of parameters (gas pressure and tube radius) on discharge operation and characteristics. Laws of similitude as well as empirical relationships between argon I and argon II emission line intensities, electron density, and electric field in the plasma have been established [fr

  11. Ion source of discharge type

    Energy Technology Data Exchange (ETDEWEB)

    Enchevich, I.B. [TRIUMF, Cyclotron Div., Vancouver, British Columbia (Canada); Korenev, S.A. [JINR, Hihg Energy Physics Lab., Dubna, Moscow (Russian Federation)

    1992-07-01

    A new scheme of ion source based on a dielectric surface sliding discharge is described. The conditions to form this type of discharge are analyzed and experimental results are shown. The main parameters of this ion source are: accelerating voltage U = 1/20kV; continuous extracted ion beam; current density j = 0.01/0.5 A/cm{sup 2}; ions of Cl, F, C, H; residual gas pressure P = 10{sup -6} Torr. A magnetic system is used to separate the different types of ions. The dielectric material in the discharge circuit (anode plasma emitter) defines the type of ions. The emission characteristics of plasma emitter and the discharge parameters are presented. The ion current yield satisfies the Child-Langmuir law. (author)

  12. Ion source of discharge type

    International Nuclear Information System (INIS)

    Enchevich, I.B.; Korenev, S.A.

    1992-07-01

    A new scheme of ion source based on a dielectric surface sliding discharge is described. The conditions to form this type of discharge are analyzed and experimental results are shown. The main parameters of this ion source are: accelerating voltage U = 1/20kV; continuous extracted ion beam; current density j = 0.01/0.5 A/cm 2 ; ions of Cl, F, C, H; residual gas pressure P = 10 -6 Torr. A magnetic system is used to separate the different types of ions. The dielectric material in the discharge circuit (anode plasma emitter) defines the type of ions. The emission characteristics of plasma emitter and the discharge parameters are presented. The ion current yield satisfies the Child-Langmuir law. (author)

  13. Radioactive discharges from Sellafield (UK)

    International Nuclear Information System (INIS)

    Pentreath, R.J.

    1985-01-01

    This study of low-level liquid radioactive discharges from the British Nuclear Fuels Ltd Sellafield site into the eastern basin of the Irish Sea, prepared on the basis of existing publications and documents, reviews chemical forms and rate of discharges, physical oceanography, sediment distribution and fisheries of the Irish Sea, behaviour of radionuclides in seawater, association with sedimentary materials, accumulation of radionuclides by biological materials, environmental monitoring, surveillance and assessment of radiation exposure of the public and impact on the environment

  14. [Study on Square Super-Lattice Pattern with Surface Discharge in Dielectric Barrier Discharge by Optical Emission Spectra].

    Science.gov (United States)

    Niu, Xue-jiao; Dong, Li-fang; Liu, Ying; Wang, Qian; Feng, Jian-yu

    2016-02-01

    Square super-lattice pattern with surface discharge consisting of central spots and dim spots is firstly observed in the mixture of argon and air by using a dielectric barrier discharge device with water electrodes. By observing the image, it is found that the central spot is located at the centriod of its surrounding four dim spots. The short-exposure image recorded by a high speed video camera shows that the dim spot results from the surface discharges (SDs). The brightness of the central spot and is quite different from that of the dim spot, which indicates that the plasma states of the central spot and the dim spot may be differentiated. The optical emission spectrum method is used to further study the several plasma parameters of the central spot and the dim spot in different argon content. The emission spectra of the N₂ second positive band (C³IIu --> B³ IIg) are measured, from which the molecule vibration temperatures of the central spot and the dim spot are calculated respectively. The broadening of spectral line 696.57 nm (2P₂-->1S₅) is used to study the electron densities of the central spot and the dim spot. It is found that the molecule vibration temperature and electron density of the dim spot are higher than those of the central spot in the same argon content The molecule vibration temperature and electron density of the central spot and the dim spot increase with the argon content increasing from 90% to 99.9%. The surface discharge induced by the volume discharge (VD) has the determinative effect on the formation of the dim spot The experimental results above play an important role in studying the formation mechanism of surface discharg&of square super-lattice pattern with surface discharge. In addition, the studies exert an influence on the application of surface discharge and volume discharge in different fields.

  15. Chronic obstructive pulmonary disease - adults - discharge

    Science.gov (United States)

    ... coughing up dark mucus Your fingertips or the skin around your fingernails are blue Alternative Names COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; ...

  16. Vinyl Record

    DEFF Research Database (Denmark)

    Bartmanski, Dominik; Woodward, Ian

    2018-01-01

    . This relational process means that both the material affordances and entanglements of vinyl allow us to feel, handle, experience, project, and share its iconicity. The materially mediated meanings of vinyl enabled it to retain currency in independent and collector’s markets and thus resist the planned......In this paper, we use the case of the vinyl record to show that iconic objects become meaningful via a dual process. First, they offer immersive engagements which structure user interpretations through various material experiences of handling, use, and extension. Second, they always work via...

  17. Ballooning stability of JET discharges

    International Nuclear Information System (INIS)

    Huysmans, G.T.A.; Goedbloed, J.P.; Galvao, R.M.O.; Lazzaro, E.; Smeulders, P.

    1989-01-01

    Conditions under which ballooning modes are expected to be excited have recently been obtained in two different types of discharges in JET. In the first type, extremely large pressure gradients have been produced in the plasma core through pellet injections in the current rise phase followed by strong additional heating. In the second type, the total pressure of the discharge is approaching the Troyon limit. The stability of these discharges with respect to the ideal MHD ballooning modes has been studied with the stability code HBT. The equilibria are reconstructed with the IDENTC code using the external magnetic measurements and the experimental pressure profile. The results show that the evaluated high beta discharge is unstable in the central region of the plasma. This instability is related to the low shear and not to a large pressure gradient, as expected at the Troyon limit. In the pellet discharges the regions with the large pressure gradients are unstable to ballooning modes at the time of the beta decay, which ends the period of enhanced performance. The maximum pressure gradient in these discharges is limited by the boundary of the first region of stability. The observed phenomena at the beta decay are similar to those observed at the beta limit in DIII-D and TFTR. (author)

  18. Filamentary and diffuse barrier discharges

    International Nuclear Information System (INIS)

    Kogelschatz, U.

    2001-01-01

    Barrier discharges, sometimes also referred to as dielectric-barrier discharges or silent discharges, are characterized by the presence of at least one insulating layer in contact with the discharge between two planar or cylindrical electrodes connected to an ac power supply. The main advantage of this type of electrical discharge is, that non-equilibrium plasma conditions in atmospheric-pressure gases can be established in an economic and reliable way. This has led to a number of important applications including industrial ozone generation, surface modification of polymers, plasma chemical vapor deposition, excitation of CO 2 lasers, excimer lamps and, most recently, large-area flat plasma display panels. Depending on the application, the width of the discharge gap can range from less than 0.1 mm to about 100 mm and the applied frequency from below line frequency to several gigahertz. Typical materials used for the insulating layer (dielectric barrier) are glass, quartz, ceramics but also thin enamel or polymer layers

  19. Electrolocation-communication discharges of the fish Gymnotus carapo L. (Gymnotidae: Gymnotiformes during behavioral sleep

    Directory of Open Access Journals (Sweden)

    Stopa R.M.

    1999-01-01

    Full Text Available Technical problems have hampered the study of sleep in teleosts. The electrical discharges of Gymnotus carapo L. (Gymnotidae: Gymnotiformes were monitored to evaluate their ease and reliability as parameters to study sleep. The discharges were detected by electrodes immersed in a glass aquarium and were recorded on a conventional polygraph. G. carapo showed conspicuous signs of behavioral sleep. During these periods, opercular beat rates were counted, electric discharges recorded, and the "sharp discharge increase" (SDI of the orienting reflex was investigated. All 20 animals monitored maintained electrical discharges during behavioral sleep. The discharge frequencies during sleep (50.3 ± 10.4 Hz were not significantly different from those observed when the fish was awake and inactive (57.2 ± 12.1 Hz (Wilcoxon matched-pairs signed-ranks test, P>0.05. However, the SDI, which was prevalent in the awake fish, was not observed during periods of behavioral sleep. Additional observations showed that the species had cannibalistic habits. When presented with electrical discharges from a conspecific, the sleeping fish showed an initial decrease or pause in discharge frequency, while the awake fish did not have this response. We conclude that the electrical discharges of G. carapo were not conspicuous indicators of behavioral sleep. Discharges may have been maintained during sleep for sensory purposes, i.e., conspecific detection and avoidance of cannibalistic attacks.

  20. Record Club

    CERN Multimedia

    Record Club

    2011-01-01

    http://cern.ch/Record.Club November  Selections Just in time for the holiday season, we have added a number of new CDs and DVDs into the Club. You will find the full lists at http://cern.ch/record.club; select the "Discs of the Month" button on the left side on the left panel of the web page and then Nov 2011. New films include the all 5 episodes of Fast and Furious, many of the most famous films starring Jean-Paul Belmondo and those of Louis de Funes and some more recent films such as The Lincoln Lawyer and, according to some critics, Woody Allen’s best film for years – Midnight in Paris. For the younger generation there is Cars 2 and Kung Fu Panda 2. New CDs include the latest releases by Adele, Coldplay and the Red Hot Chili Peppers. We have also added the new Duets II CD featuring Tony Bennett singing with some of today’s pop stars including Lady Gaga, Amy Winehouse and Willy Nelson. The Club is now open every Monday, Wednesday and Friday ...

  1. Record Club

    CERN Multimedia

    Record Club

    2011-01-01

    http://cern.ch/Record.Club June Selections We have put a significant number of new CDs and DVDs into the Club You will find the full lists at http://cern.ch/record.club and select the «Discs of the Month» button on the left side on the left panel of the web page and then June 2011. New films include the latest Action, Suspense and Science Fiction film hits, general drama movies including the Oscar-winning The King’s Speech, comedies including both chapter of Bridget Jones’s Diary, seven films for children and a musical. Other highlights include the latest Harry Potter release and some movies from the past you may have missed including the first in the Terminator series. New CDs include the latest releases by Michel Sardou, Mylene Farmer, Jennifer Lopez, Zucchero and Britney Spears. There is also a hits collection from NRJ. Don’t forget that the Club is now open every Monday, Wednesday and Friday lunchtimes from 12h30 to 13h00 in Restaurant 2, Building 504. (C...

  2. Record club

    CERN Document Server

    Record club

    2010-01-01

      Bonjour a tous, Voici les 24 nouveaux DVD de Juillet disponibles depuis quelques jours, sans oublier les 5 CD Pop musique. Découvrez la saga du terroriste Carlos, la vie de Gainsbourg et les aventures de Lucky Luke; angoissez avec Paranormal Activity et évadez vous sur Pandora dans la peau d’Avatar. Toutes les nouveautés sont à découvrir directement au club. Pour en connaître la liste complète ainsi que le reste de la collection du Record Club, nous vous invitons sur notre site web: http://cern.ch/crc. Toutes les dernières nouveautés sont dans la rubrique « Discs of the Month ». Rappel : le club est ouvert les Lundis, Mercredis, Vendredis de 12h30 à 13h00 au restaurant n°2, bâtiment 504. A bientôt chers Record Clubbers.  

  3. Record Club

    CERN Multimedia

    Record Club

    2011-01-01

    http://cern.ch/Record.Club Nouveautés été 2011 Le club de location de CDs et de DVDs vient d’ajouter un grand nombre de disques pour l’été 2011. Parmi eux, Le Discours d’un Roi, oscar 2011 du meilleur film et Harry Potter les reliques de la mort (1re partie). Ce n’est pas moins de 48 DVDs et 10 CDs nouveaux qui vous sont proposés à la location. Il y en a pour tous les genres. Alors n’hésitez pas à consulter notre site http://cern.ch/record.club, voir Disc Catalogue, Discs of the month pour avoir la liste complète. Le club est ouvert tous les Lundi, Mercredi, Vendredi de 12h30 à 13h dans le bâtiment du restaurent N°2 (Cf. URL: http://www.cern.ch/map/building?bno=504) A très bientôt.  

  4. Classification of electrical discharges in DC Accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Banerjee, Srutarshi, E-mail: sruban.stephens@gmail.com [Accelerator and Pulse Power Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Deb, A.K. [Department of Electrical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302 (India); Rajan, Rehim N. [Accelerator and Pulse Power Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Kishore, N.K. [Department of Electrical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302 (India)

    2016-08-11

    Controlled electrical discharge aids in conditioning of the system while uncontrolled discharges damage its electronic components. DC Accelerator being a high voltage system is no exception. It is useful to classify electrical discharges according to the severity. Experimental prototypes of the accelerator discharges are developed. Photomultiplier Tubes (PMTs) are used to detect the signals from these discharges. Time and Frequency domain characteristics of the detected discharges are used to extract features. Machine Learning approaches like Fuzzy Logic, Neural Network and Least Squares Support Vector Machine (LSSVM) are employed to classify the discharges. This aids in detecting the severity of the discharges.

  5. A descriptive study of urethral discharge among men in Fiji.

    Science.gov (United States)

    Gaunavinaka, Lavenia; Balak, Dashika; Varman, Sumanthla; Ram, Sharan; Graham, Stephen M

    2014-10-17

    Urethral discharge is a common presentation of sexually transmitted infection (STI) in men and known pathogens include Neisseria gonorrhoeae and Chlamydia trachomatis. There are no published data of the burden of urethral discharge among men in Fiji. To evaluate urethral discharge among men to determine the incidence, the frequency of recurrence and reported at-risk behaviour. We conducted a retrospective, descriptive study of clinical records of all men presenting with urethral discharge to two major reproductive health clinics. Data collected included self-reported at-risk behaviours, results of abnormal syphilis serology and antibiotics prescribed. The frequency of recurrence in the following 1-2 years of initial presentation was determined along with microbiological findings from urethral swab in this group. A total of 748 males presented with urethral discharge to the clinic in one year. This represents an incidence rate of at least 295 per 100,000 adult males per year in the study population. Within the next 1-2 years of the initial presentation, 102 (14%) of these re-presented out of which 42 had urethral swab taken for etiological diagnosis. The commonest isolate was Neisseria gonorrhoeae. Results of syphilis tests were available for 560 (75%) of patients and 29 (5%) were positive. Recurrence was not associated with self-reported at-risk behaviours. The incidence of urethral discharge among males in Fiji is very high and prevention strategies are urgently needed.

  6. Facilitating the Information Exchange Using a Modular Electronic Discharge Summary.

    Science.gov (United States)

    Denecke, Kerstin; Dittli, Pascal A; Kanagarasa, Niveadha; Nüssli, Stephan

    2018-01-01

    Discharge summaries are a standard communication tool delivering important clinical information from inpatient to ambulatory care. To ensure a high quality, correctness and completeness, the generation process is time consuming. It requires also contributions of multiple persons. This is problematic since the primary care provider needs the information from the discharge summary for continuing the intended treatment. To address this challenge, we developed a concept for exchanging a modular electronic discharge summary. Through a literature review and interviews with multiple stakeholders, we analysed existing processes and derived requirements for an improved communication of the discharge summary. In this paper, we suggest a concept of a modular electronic discharge summary that is exchanged through the electronic patient dossier in CDA CH level 2 documents. Until 2020, all Swiss hospitals are obliged to connect to the electronic patient dossier. Our concept allows to access already completed modules of the discharge summary from the primary care side, before the entire report is entirely finalised. The data is automatically merged with the local patient record on the physician side and prepared for data integration into the practice information system. Our concept offers the opportunity not only to improve the information exchange between hospital and primary care, but it also provides a potential use case and demonstrates a benefit of the electronic patient dossier for primary care providers who are so far not obliged to connect to the patient dossier in Switzerland.

  7. Do prehospital discharge pacemaker checks provide any additional clinical benefit?

    Science.gov (United States)

    Wheelan, Kevin R; Legge, Darlene M; Sakowski, Brent C; Bruce, Susan S; Roberts, David C; Johnston, L Murphy; Moore, B Jane; Beveridge, Thomas P; Wells, Peter J; Vallabahn, Ravi; Donsky, Michael S; Franklin, Jay O

    2005-08-01

    We performed a retrospective analysis of 250 records of consecutive, newly implanted, pacemaker patients from a single center to determine the rate of postimplant complications and observations discovered before and during the prehospital discharge evaluation. No observations occurred in 246 of 250 patients (98.4%) (1-sided 95% confidence interval 96.4%). Of the 250 patients, 4 had observations that were discovered at the prehospital discharge check and required reprogramming to increase the sensitivity safety margin (3 atrial and 1 ventricular). We documented only 1 complication that was discovered before the predischarge evaluation through telemetry and resulted in an atrial lead revision.

  8. RECORD CLUB

    CERN Multimedia

    Record Club

    2010-01-01

    DVD James Bond – Series Complete To all Record Club Members, to start the new year, we have taken advantage of a special offer to add copies of all the James Bond movies to date, from the very first - Dr. No - to the latest - Quantum of Solace. No matter which of the successive 007s you prefer (Sean Connery, George Lazenby, Roger Moore, Timothy Dalton, Pierce Brosnan or Daniel Craig), they are all there. Or perhaps you have a favourite Bond Girl, or even perhaps a favourite villain. Take your pick. You can find the full selection listed on the club web site http://cern.ch/crc; use the panel on the left of the page “Discs of the Month” and select Jan 2010. We remind you that we are open on Mondays, Wednesdays and Fridays from 12:30 to 13:00 in Restaurant 2 (Bldg 504).

  9. Record dynamics

    DEFF Research Database (Denmark)

    Robe, Dominic M.; Boettcher, Stefan; Sibani, Paolo

    2016-01-01

    When quenched rapidly beyond their glass transition, colloidal suspensions fall out of equilibrium. The pace of their dynamics then slows down with the system age, i.e., with the time elapsed after the quench. This breaking of time translational invariance is associated with dynamical observables...... which depend on two time-arguments. The phenomenology is shared by a broad class of aging systems and calls for an equally broad theoretical description. The key idea is that, independent of microscopic details, aging systems progress through rare intermittent structural relaxations that are de......-facto irreversible and become increasingly harder to achieve. Thus, a progression of record-sized dynamical barriers are traversed in the approach to equilibration. Accordingly, the statistics of the events is closely described by a log-Poisson process. Originally developed for relaxation in spin glasses...

  10. Record breakers

    CERN Multimedia

    Antonella Del Rosso

    2012-01-01

    In the sixties, CERN’s Fellows were but a handful of about 50 young experimentalists present on site to complete their training. Today, their number has increased to a record-breaking 500. They come from many different fields and are spread across CERN’s different activity areas.   “Diversifying the Fellowship programme has been the key theme in recent years,” comments James Purvis, Head of the Recruitment, Programmes and Monitoring group in the HR Department. “In particular, the 2005 five-yearly review introduced the notion of ‘senior’ and ‘junior’ Fellowships, broadening the target audience to include those with Bachelor-level qualifications.” Diversification made CERN’s Fellowship programme attractive to a wider audience but the number of Fellows on site could not have increased so much without the support of EU-funded projects, which were instrumental in the growth of the programme. ...

  11. Application of FISH 7q in MDS patients without monosomy 7 or 7q deletion by conventional G-banding cytogenetics: does -7/7q- detection by FISH have prognostic value?

    Science.gov (United States)

    Ademà, Vera; Hernández, Jesús María; Abáigar, María; Lumbreras, Eva; Such, Esperanza; Calull, Anna; Dominguez, Esther; Arenillas, Leonor; Mallo, Mar; Cervera, José; Marugán, Isabel; Tormo, Mar; García, Francisca; González, Teresa; Luño, Elisa; Sanzo, Carmen; Martín, María Luisa; Fernández, Manuela; Costa, Dolors; Blázquez, Beatriz; Barreña, Beatriz; Marco, Fernando; Batlle, Ana; Buño, Ismael; Martínez-Laperche, Carolina; Noriega, Víctor; Collado, Rosa; Ivars, David; Carbonell, Félix; Vallcorba, Isabel; Melero, Josefa; Delgado, Elena; Vargas, María Teresa; Grau, Javier; Salido, Marta; Espinet, Blanca; Melero, Carme; Florensa, Lourdes; Pedro, Carmen; Solé, Francesc

    2013-04-01

    Chromosomal abnormalities are detected in 40-60% of patients with de novo myelodysplastic syndromes (MDS). This study used the FISH technique in 773 patients with de novo MDS without evidence of monosomy 7 (-7) or 7q deletion (7q-) by conventional G-banding cytogenetics (CC) to analyze their prognostic impact by FISH alone. FISH detected -7/7q- in 5.2% of patients. Presence of -7/7q- was associated with shorter overall survival than absence of such aberrations. Our results suggest that FISH 7q could be beneficial in patients with intermediate WHO morphologic risk stratification and no evidence of -7/7q- by CC. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. The prognostic value of monosomal karyotype (MK) in higher-risk patients with myelodysplastic syndromes treated with 5-Azacitidine. A retrospective analysis of the Hellenic (Greek) MDS Study Group.

    Science.gov (United States)

    Papageorgiou, Sotirios G; Vasilatou, Diamantina; Kontos, Christos K; Kotsianidis, Ioannis; Symeonidis, Argiris; Galanopoulos, Athanasios G; Hatzimichael, Eleftheria; Megalakaki, Aekaterini; Poulakidas, Elias; Diamantopoulos, Panagiotis; Vassilakopoulos, Theodoros; Zikos, Panagiotis; Papadaki, Helen; Mparmparousi, Despoina; Bouronikou, Eleni; Panayiotidis, Panayiotis; Viniou, Nora-Athina; Pappa, Vassiliki

    2018-04-16

    In this study, we investigated the incidence and prognostic impact of monosomal karyotype (MK) in 405 higher-risk MDS patients treated with 5-AZA. The MK was present in 66 out of 405 (16.3%) patients, most of whom had complex karyotype (CK). MK was strongly associated with CK and the cytogenetic risk defined according to IPSS-R, as well as with high-risk disease, according to IPSS (P=0.029), IPSS-R (PMDS treated with 5-AZA. Furthermore, we showed that in MDS with high or very-high IPSS-R risk score, MK can further distinguish patients with worse outcome. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  13. Magnitude of Anemia at Discharge Increases 30-Day Hospital Readmissions.

    Science.gov (United States)

    Koch, Colleen G; Li, Liang; Sun, Zhiyuan; Hixson, Eric D; Tang, Anne; Chagin, Kevin; Kattan, Michael; Phillips, Shannon C; Blackstone, Eugene H; Henderson, J Michael

    2017-12-01

    Anemia during hospitalization is associated with poor health outcomes. Does anemia at discharge place patients at risk for hospital readmission within 30 days of discharge? Our objectives were to examine the prevalence and magnitude of anemia at hospital discharge and determine whether anemia at discharge was associated with 30-day readmissions among a cohort of hospitalizations in a single health care system. From January 1, 2009, to August 31, 2011, there were 152,757 eligible hospitalizations within a single health care system. The endpoint was any hospitalization within 30 days of discharge. The University HealthSystem Consortium's clinical database was used for demographics and comorbidities; hemoglobin values are from the hospitals' electronic medical records, and readmission status was obtained from the University HealthSystem Consortium administrative data systems. Mild anemia was defined as hemoglobin of greater than 11 to less than 12 g/dl in women and greater than 11 to less than 13 g/dl in men; moderate, greater than 9 to less than or equal to 11 g/dl; and severe, less than or equal to 9 g/dl. Logistic regression was used to assess the association of anemia and 30-day readmissions adjusted for demographics, comorbidity, and hospitalization type. Among 152,757 hospitalizations, 72% of patients were discharged with anemia: 31,903 (21%), mild; 52,971 (35%), moderate; and 25,522 (17%), severe. Discharge anemia was associated with severity-dependent increased odds for 30-day hospital readmission compared with those without anemia: for mild anemia, 1.74 (1.65-1.82); moderate anemia, 2.76 (2.64-2.89); and severe anemia, 3.47 (3.30-3.65), P < 0.001. Anemia at discharge is associated with a severity-dependent increased risk for 30-day readmission. A strategy focusing on anemia treatment care paths during index hospitalization offers an opportunity to influence subsequent readmissions.

  14. Glow discharge in singlet oxygen

    International Nuclear Information System (INIS)

    Vagin, N.P.; Ionin, A.A.; Klimachev, Yu.M.; Sinitsyn, D.V.; Yuryshev, N.N.; Kochetov, I.V.; Napartovich, A.P.

    2003-01-01

    Currently, there is no experimental data on the plasma balance in gas mixtures with a high content of singlet delta oxygen O 2 ( 1 Δ g ). These data can be obtained by studying the parameters of an electric discharge in singlet oxygen produced by a chemical generator. The O 2 ( 1 Δ g ) molecules significantly change the kinetics of electrons and negative ions in plasma. Hence, the discharge conditions at low and high O 2 ( 1 Δ g ) concentrations are very different. Here, the parameters of the positive column of a glow discharge in a gas flow from a chemical singlet-oxygen generator are studied. It is experimentally shown that, at an O 2 ( 1 Δ g ) concentration of 50% and at pressures of 1.5 and 2 torr, the electric field required to sustain the discharge is considerably lower than in the case when all of the oxygen molecules are in the ground state. A theoretical model of the glow discharge is proposed whose predictions are in good agreement with the experimental data

  15. Characterization of electrical discharges during spark anodization of zirconium in different electrolytes

    International Nuclear Information System (INIS)

    Santos, Janaina S.; Lemos, Sherlan G.; Gonçalves, Wesley N.; Bruno, Odemir M.; Pereira, Ernesto C.

    2014-01-01

    The evolution of the electrical discharges parameters during spark anodization of metallic Zr under galvanostatic regime have been investigated by image analysis in phosphoric and oxalic acid electrolytes. The experiments were recorder using a high-speed video camera during the entire anodization with a resolution of 1.7 ms for determination of discharge lifetime and a standard resolution of 33 ms (real-time imaging) for determination of the average area and discharge population density. The discharge behavior was dependent of the current density, electrolyte composition and anodization time. During breakdown process, sparks discharges are progressively turned to micro-arcs, which can be seen by enlargement of discharge area, gradual increase of lifetime and reduction of discharge population density. A factorial design was used to estimate the effects of experimental conditions on the discharge behavior. The current density and electrolyte composition were the most important factors that affected the discharge population density. The anodization time and the electrolyte composition were the main factor that influenced the discharge area and lifetime. In comparison with the voltage vs. time curve, the results demonstrate important features of the process and the changes of the electrical discharges characteristics during the experiments

  16. Characterization of the flowing afterglows of an N{sub 2}-O{sub 2} reduced-pressure discharge: setting the operating conditions to achieve a dominant late afterglow and correlating the NO{sub {beta}} UV intensity variation with the N and O atom densities

    Energy Technology Data Exchange (ETDEWEB)

    Boudam, M K [Groupe de Physique des Plasmas, Universite de Montreal, CP 6128, Succursale Centre-Ville, Montreal H3C 3J7, Quebec (Canada); Saoudi, B [Groupe de Physique des Plasmas, Universite de Montreal, CP 6128, Succursale Centre-Ville, Montreal H3C 3J7, Quebec (Canada); Moisan, M [Groupe de Physique des Plasmas, Universite de Montreal, CP 6128, Succursale Centre-Ville, Montreal H3C 3J7, Quebec (Canada); Ricard, A [Centre de Physique Atomique de Toulouse (CPAT), 118, route de Narbonne, Universite Paul Sabatier, 31062-Toulouse (France)

    2007-03-21

    The flowing afterglow of an N{sub 2}-O{sub 2} discharge in the 0.6-10 Torr range is examined in the perspective of achieving sterilization of medical devices (MDs) under conditions ensuring maximum UV intensity with minimum damage to polymer-based MDs. The early afterglow is shown to be responsible for creating strong erosion damage, requiring that the sterilizer be operated in a dominant late-afterglow mode. These two types of afterglow can be characterized by optical emission spectroscopy: the early afterglow is distinguished by an intense emission from the N{sub 2}{sup +} 1st negative system (band head at 391.4 nm) while the late afterglow yields an overpopulation of the v' = 11 ro-vibrational level of the N{sub 2}(B) state, indicating a reduced contribution from the early afterglow N{sub 2} metastable species. We have studied the influence of operating conditions (pressure, O{sub 2} content in the N{sub 2}-O{sub 2} mixture, distance of the discharge from the entrance to the afterglow (sterilizer) chamber) in order to achieve a dominant late afterglow that also ensures maximum and almost uniform UV intensity in the sterilization chamber. As far as operating conditions are concerned, moving the plasma source sufficiently far from the chamber entrance is shown to be a practical means for significantly reducing the density of the characteristic species of the early afterglow. Using the NO titration method, we obtain the (absolute) densities of N and O atoms in the afterglow at the NO injection inlet, a few cm before the chamber entrance: the N atom density goes through a maximum at approximately 0.3-0.5% O{sub 2} and then decreases, while the O atom density increases regularly with the O{sub 2} percentage. The spatial variation of the N atom (relative) density in the chamber is obtained by recording the emission intensity from the 1st positive system at 580 nm: in the 2-5 Torr range, this density is quite uniform everywhere in the chamber. The (relative

  17. Limited clinical efficacy of azacitidine in transfusion-dependent, growth factor-resistant, low- and Int-1-risk MDS: Results from the nordic NMDSG08A phase II trial

    International Nuclear Information System (INIS)

    Tobiasson, M; Dybedahl, I; Holm, M S; Karimi, M; Brandefors, L; Garelius, H; Grövdal, M; Högh-Dufva, I; Grønbæk, K; Jansson, M; Marcher, C; Nilsson, L; Kittang, A O; Porwit, A; Saft, L; Möllgård, L; Hellström-Lindberg, E

    2014-01-01

    This prospective phase II study evaluated the efficacy of azacitidine (Aza)+erythropoietin (Epo) in transfusion-dependent patients with lower-risk myelodysplastic syndrome (MDS). Patients ineligible for or refractory to full-dose Epo+granulocyte colony stimulation factors for >8 weeks and a transfusion need of ⩾4 units over 8 weeks were included. Aza 75 mg m −2 d −1 , 5/28 days, was given for six cycles; non-responding patients received another three cycles combined with Epo 60 000 units per week. Primary end point was transfusion independence (TI). All patients underwent targeted mutational screen for 42 candidate genes. Thirty enrolled patients received ⩾one cycle of Aza. Ten patients discontinued the study early, 7 due to adverse events including 2 deaths. Thirty-eight serious adverse events were reported, the most common being infection. Five patients achieved TI after six cycles and one after Aza+Epo, giving a total response rate of 20%. Mutational screening revealed a high frequency of recurrent mutations. Although no single mutation predicted for response, SF3A1 (n=3) and DNMT3A (n=4) were only observed in non-responders. We conclude that Aza can induce TI in severely anemic MDS patients, but efficacy is limited, toxicity substantial and most responses of short duration. This treatment cannot be generally recommended in lower-risk MDS. Mutational screening revealed a high frequency of mutations

  18. Outcome of Allogeneic Stem Cell Transplantation for Patients Transformed to Myelodysplastic Syndrome or Leukemia from Severe Aplastic Anemia: A Report from the MDS Subcommittee of the Chronic Malignancies Working Party and the Severe Aplastic Anemia Working Party of the European Group for Blood and Marrow Transplantation

    NARCIS (Netherlands)

    Hussein, A.A.; Halkes, C.M.; Socie, G.; Tichelli, A.; Borne, P.A. von dem; Schaap, M.N.; Foa, R.; Ganser, A.; Dufour, C.; Bacigalupo, A.; Locasciulli, A.; Aljurf, M.; Peters, C.; Robin, M.; Biezen, A.A. van; Volin, L.; Witte, T.J. de; Marsh, J.; Passweg, J.R.; Kroger, N.; et al.,

    2014-01-01

    One hundred and forty patients who had undergone hematopoietic stem cell transplantation (HSCT) for myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML) transformation after treatment of severe aplastic anemia (SAA) were identified in the European Group for Blood and Marrow

  19. Electron runaway in rf discharges

    International Nuclear Information System (INIS)

    Chen, F.F.

    1992-10-01

    The critical electric field is computed as a function of pressure and starting energy for electrons to run away to high energies in moderate pressure discharges. The runaway conditions depend critically on the shape of the elastic cross section vs. energy curve. Computations are made for H, H 2 , and He gases, and it is shown that runaway occurs much more readily in atomic hydrogen than in the other gases. The values of the runaway fields are larger than would normally occur in dc discharges, where large voltages would lead to arc formation. However, in rf discharges such electric fields can be sustained over times long compared to electron transit times but short compared to ion transit times. (author)

  20. Discharge quenching circuit for counters

    International Nuclear Information System (INIS)

    Karasik, A.S.

    1982-01-01

    A circuit for quenching discharges in gas-discharge detectors with working voltage of 3-5 kV based on transistors operating in the avalanche mode is described. The quenching circuit consists of a coordinating emitter follower, amplifier-shaper for avalanche key cascade control which changes potential on the counter electrodes and a shaper of discharge quenching duration. The emitter follower is assembled according to a widely used flowsheet with two transistors. The circuit permits to obtain a rectangular quenching pulse with front of 100 ns and an amplitude of up to 3.2 kV at duration of 500 μm-8 ms. Application of the quenching circuit described permits to obtain countering characteristics with the slope less than or equal to 0.02%/V and plateau extent greater than or equal to 300 V [ru

  1. Record Club

    CERN Document Server

    Record Club

    2012-01-01

      March  Selections By the time this appears, we will have added a number of new CDs and DVDs into the Club. You will find the full lists at http://cern.ch/record.club; select the "Discs of the Month" button on the left panel of the web page and then Mar 2012. New films include recent releases such as Johnny English 2, Bad Teacher, Cowboys vs Aliens, and Super 8. We are also starting to acquire some of the classic films we missed when we initiated the DVD section of the club, such as appeared in a recent Best 100 Films published by a leading UK magazine; this month we have added Spielberg’s Jaws and Scorsese’s Goodfellas. If you have your own ideas on what we are missing, let us know. For children we have no less than 8 Tin-Tin DVDs. And if you like fast moving pop music, try the Beyonce concert DVD. New CDs include the latest releases from Paul McCartney, Rihanna and Amy Winehouse. There is a best of Mylene Farmer, a compilation from the NRJ 201...

  2. State Waste Discharge Permit application, 183-N Backwash Discharge Pond

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    As part of the Hanford Federal Facility Agreement and Consent Order negotiations (Ecology et al. 1994), the US Department of Energy, Richland Operations Office, the US Environmental Protection Agency, and the Washington State Department of Ecology agreed that liquid effluent discharges to the ground on the Hanford Site which affect groundwater or have the potential to affect groundwater would be subject to permitting under the structure of Chapter 173--216 (or 173--218 where applicable) of the Washington Administrative Code, the State Waste Discharge Permit Program. As a result of this decision, the Washington State Department of Ecology and the US Department of Energy, Richland Operations Office entered into Consent Order No. DE91NM-177, (Ecology and DOE-RL 1991). The Consent Order No. DE91NM-177 requires a series of permitting activities for liquid effluent discharges. Liquid effluents on the Hanford Site have been classified as Phase I, Phase II, and Miscellaneous Streams. The Consent Order No. DE91NM-177 establishes milestones for State Waste Discharge Permit application submittals for all Phase I and Phase II streams, as well as the following 11 Miscellaneous Streams as identified in Table 4 of the Consent Order No. DE91NM-177.

  3. Current-Induced Membrane Discharge

    DEFF Research Database (Denmark)

    Andersen, Mathias Bækbo; van Soestbergen, M.; Mani, A.

    2012-01-01

    . Salt depletion leads to a large electric field resulting in a local pH shift within the membrane with the effect that the membrane discharges and loses its ion selectivity. Since salt co-ions, H+ ions, and OH- ions contribute to OLC, CIMD interferes with electrodialysis (salt counterion removal...... neglects chemical effects and remains to be quantitatively tested. Here, we show that charge regulation and water self-ionization can lead to OLC by "current-induced membrane discharge'' (CIMD), even in the absence of fluid flow, in ion-exchange membranes much thicker than the local Debye screening length...

  4. Plasma Discharge in Toroidal System

    International Nuclear Information System (INIS)

    Usada, Widdi; Suryadi; Purwadi, Agus; Kasiyo

    1996-01-01

    A toroidal discharge apparatus has been made as an initial research in magnetic confinement system. This system consists of a capacitor, a RF source, an igniter system, a primary coil, a torus, and completed by Rogowski probe as a current detector. In this system, the discharge occurs when the minimum voltage is operated at 5 kV. The experiment result shows that the coupling factor is 0.35, it is proved that there is an equality between estimated and measurement results of the primary inductance i.e 8.5 μH

  5. Taming Instabilities in Plasma Discharges

    International Nuclear Information System (INIS)

    Klinger, T.; Krahnstover, N. O.; Mausbach, T.; Piel, A.

    2000-01-01

    Recent experimental work on taming instabilities in plasma discharges is discussed. Instead of suppressing instabilities, it is desired to achieve control over their dynamics, done by perturbing appropriately the current flow in the external circuit of the discharge. Different discrete and continuous feedback as well as open-loop control schemes are applied. Chaotic oscillations in plasma diodes are controlled using the OGY discrete feedback scheme. This is demonstrated both in experiment and computer simulation. Weakly developed ionization wave turbulence is tamed by continuous feedback control. Open-loop control of stochastic fluctuations - stochastic resonance - is demonstrated in a thermionic plasma diode. (author)

  6. Corona discharge ion mobility spectrometry at reduced pressures

    International Nuclear Information System (INIS)

    Tabrizchi, Mahmoud; Rouholahnejad, Fereshteh

    2004-01-01

    Ion mobility spectrometers (IMSs) normally operate at ambient pressure. In this work an IMS cell has been designed and constructed to allow the pressure to be reduced inside the IMS cell. In this cell, corona discharge was employed as the ionization source. Reducing pressure affected both the discharge and the performance of the IMS. The discharge current was observed to increase with reducing pressure while the ignition potential decreased. The ion current received at the collector plate was also increased about 50 times when the pressure was reduced from ambient pressure to 15 Torr. The higher ion current can lead to an extended dynamic range. IMS spectra were recorded at various pressures and the results show that the drift times shift perfectly linear with pressure. This suggests that unlike temperature, pressure correction for ion mobility spectra is as simple as multiplying the drift times by a factor of 760/P

  7. Study of the electron energy distribution function in plasma produced by a rf discharge in a mixture of inert gases

    International Nuclear Information System (INIS)

    Vagner, S.D.; Ignat'ev, B.K.

    1983-01-01

    Electron energy distribution functions (EEDF) are recorded in an rf discharge in a mixture of neon and argon. The rates of different ionization processes and the energy losses of the electrons in the bulk of the discharge are calculated. The experimentally recorded electron energy distribution functions are compared with distributions calculated using a nonlocal theory. The effect of an rf voltage in the probe circuit on the recorded electron energy distribution functions is investigated experimentally

  8. Use of radars to monitor stream discharge by noncontact methods

    Science.gov (United States)

    Costa, J.E.; Cheng, R.T.; Haeni, F.P.; Melcher, N.; Spicer, K.R.; Hayes, E.; Plant, W.; Hayes, K.; Teague, C.; Barrick, D.

    2006-01-01

    Conventional measurements of river flows are costly, time‐consuming, and frequently dangerous. This report evaluates the use of a continuous wave microwave radar, a monostatic UHF Doppler radar, a pulsed Doppler microwave radar, and a ground‐penetrating radar to measure river flows continuously over long periods and without touching the water with any instruments. The experiments duplicate the flow records from conventional stream gauging stations on the San Joaquin River in California and the Cowlitz River in Washington. The purpose of the experiments was to directly measure the parameters necessary to compute flow: surface velocity (converted to mean velocity) and cross‐sectional area, thereby avoiding the uncertainty, complexity, and cost of maintaining rating curves. River channel cross sections were measured by ground‐penetrating radar suspended above the river. River surface water velocity was obtained by Bragg scattering of microwave and UHF Doppler radars, and the surface velocity data were converted to mean velocity on the basis of detailed velocity profiles measured by current meters and hydroacoustic instruments. Experiments using these radars to acquire a continuous record of flow were conducted for 4 weeks on the San Joaquin River and for 16 weeks on the Cowlitz River. At the San Joaquin River the radar noncontact measurements produced discharges more than 20% higher than the other independent measurements in the early part of the experiment. After the first 3 days, the noncontact radar discharge measurements were within 5% of the rating values. On the Cowlitz River at Castle Rock, correlation coefficients between the USGS stream gauging station rating curve discharge and discharge computed from three different Doppler radar systems and GPR data over the 16 week experiment were 0.883, 0.969, and 0.992. Noncontact radar results were within a few percent of discharge values obtained by gauging station, current meter, and hydroacoustic methods

  9. Spatio-temporal characteristics of self-pulse in hollow cathode discharge

    International Nuclear Information System (INIS)

    Jing, Ha; He, Shoujie

    2015-01-01

    The characteristics of self-pulse in hollow cathode discharge at low pressure have been investigated. The voltage-current (V-I) curves, the influence of ballast resistor on the self-pulses, and the evolution of current and voltage are measured. Both the axial and radial spatio-temporal discharge images of self-pulse are recorded. The results show that there exists the hysteresis effect in the present hollow cathode discharge. The high value of ballast resistors is favourable for the observation of self-pulses. The process of the self-pulse can be divided into three stages from the temporal discharge images, i.e., the pre-discharge, the transition from mainly axial electric field to mainly radial electric field, and the decaying process. The self-pulse is suggested to originate from the mode transition of the discharge in essence

  10. Electric Organ Discharges of Mormyrid Fish as a Possible Cue for Predatory Catfish

    Science.gov (United States)

    Hanika, S.; Kramer, B.

    During reproductive migration the electroreceptive African sharptooth catfish, Clarias gariepinus (Siluriformes), preys mainly on a weakly electric fish, the bulldog Marcusenius macrolepidotus (Mormyridae; Merron 1993). This is puzzling because the electric organ discharges of known Marcusenius species are pulses of a duration (system (optimum sensitivity, 10-30Hz Peters and Bretschneider 1981). On the recent discovery that M. macrolepidotus males emit discharges lasting approximately ten times longer than those of females (Kramer 1997a) we determined behavioral thresholds for discharges of both sexes, using synthetic playbacks of field-recorded discharges. C. gariepinus detected M. macrolepidotus male discharges down to a field gradient of 103μVpeak-peak/cm and up to a distance of 1.5m at natural field conditions. In contrast, thresholds for female discharges were not reached with our setup, and we presume the bulldogs eaten by catfish are predominantly male.

  11. Spheres of discharge of springs

    Science.gov (United States)

    Springer, Abraham E.; Stevens, Lawrence E.

    2009-02-01

    Although springs have been recognized as important, rare, and globally threatened ecosystems, there is as yet no consistent and comprehensive classification system or common lexicon for springs. In this paper, 12 spheres of discharge of springs are defined, sketched, displayed with photographs, and described relative to their hydrogeology of occurrence, and the microhabitats and ecosystems they support. A few of the spheres of discharge have been previously recognized and used by hydrogeologists for over 80 years, but others have only recently been defined geomorphologically. A comparison of these spheres of discharge to classification systems for wetlands, groundwater dependent ecosystems, karst hydrogeology, running waters, and other systems is provided. With a common lexicon for springs, hydrogeologists can provide more consistent guidance for springs ecosystem conservation, management, and restoration. As additional comprehensive inventories of the physical, biological, and cultural characteristics are conducted and analyzed, it will eventually be possible to associate spheres of discharge with discrete vegetation and aquatic invertebrate assemblages, and better understand the habitat requirements of rare or unique springs species. Given the elevated productivity and biodiversity of springs, and their highly threatened status, identification of geomorphic similarities among spring types is essential for conservation of these important ecosystems.

  12. Problems with textile wastewater discharge

    International Nuclear Information System (INIS)

    Rantala, Pentti

    1987-01-01

    The general character of textile industry wastewaters is briefly discussed. General guidelines and practice in Finland when discharging textile industry wastewaters to municipal sewer systems is described. A survey revealed that most municipalities experience some problems due to textile industry wastewaters. Pretreatment is not always practiced and in some cases pretreatment is not operated efficiently. (author)

  13. Discharge measurements at gaging stations

    Science.gov (United States)

    Turnipseed, D. Phil; Sauer, Vernon B.

    2010-01-01

    The techniques and standards for making discharge measurements at streamflow gaging stations are described in this publication. The vertical axis rotating-element current meter, principally the Price current meter, has been traditionally used for most measurements of discharge; however, advancements in acoustic technology have led to important developments in the use of acoustic Doppler current profilers, acoustic Doppler velocimeters, and other emerging technologies for the measurement of discharge. These new instruments, based on acoustic Doppler theory, have the advantage of no moving parts, and in the case of the acoustic Doppler current profiler, quickly and easily provide three-dimensional stream-velocity profile data through much of the vertical water column. For much of the discussion of acoustic Doppler current profiler moving-boat methodology, the reader is referred to U.S. Geological Survey Techniques and Methods 3-A22 (Mueller and Wagner, 2009). Personal digital assistants (PDAs), electronic field notebooks, and other personal computers provide fast and efficient data-collection methods that are more error-free than traditional hand methods. The use of portable weirs and flumes, floats, volumetric tanks, indirect methods, and tracers in measuring discharge are briefly described.

  14. Ions mobilities in corona discharge

    International Nuclear Information System (INIS)

    Bakhtaev, Sh. A.; Bochkareva, G. V.; Sydykova, G. K.

    2000-01-01

    Ion mobility in unipolar corona at small inter-electron distances (up to 0.01 m) when as coroning element serves micro-wire is consider. Experimental data of ion mobility in corona discharge external zone in atmospheric air are obtained and its comparative analysis with known data is worked out. (author)

  15. Air corona discharge chemical kinetics

    International Nuclear Information System (INIS)

    Kline, L.E.; Kanter, I.E.

    1984-01-01

    We have theoretically studied the initial chemical processing steps which occur in pulseless, negative, dc corona discharges in flowing air. A rate equation model is used because these discharges consist of a very small ionization zone near the pin with most of the pin-plane gap filled by a drift zone where both the electric field and the electron density are relatively uniform. The primary activated species are N 2 (A),O and O 2 (a 1 Δ). The predicted activated species density due to one discharge is 100 ppm per ms . mA cm 2 assuming E/n=60 Td. In pure, dry air the final product due to these activated species is primarily O 3 . The NO /sub x/ production is about 0.5 ppm per mA. In moist air there is an additional production of about 1.5 ppm per mA of HO /sub x/ species. The predicted ozone formation reactions will be ''intercepted'' when impurities are present in the air. Impurities present at densities below about 0.1% will react primarily with the activated species rather than with electrons. Hence the predicted activated species density provides an estimate of the potential chemical processing performance of the discharge

  16. Electronic Discharge Letter Mobile App

    NARCIS (Netherlands)

    Lezcano, Leonardo; Triana, Michel; Ternier, Stefaan; Hartkopf, Kathleen; Stieger, Lina; Schroeder, Hanna; Sopka, Sasa; Drachsler, Hendrik; Maher, Bridget; Henn, Patrick; Orrego, Carola; Specht, Marcus

    2014-01-01

    The electronic discharge letter mobile app takes advantage of Near Field Communication (NFC) within the PATIENT project and a related post-doc study. NFC enabled phones to read passive RFID tags, but can also use this short-range wireless technology to exchange (small) messages. NFC in that sense

  17. Discharge cleaning of carbon deposits

    International Nuclear Information System (INIS)

    Mozetic, M.; Vesel, A.; Drenik, A.

    2006-01-01

    Experimental results of discharge cleaning of carbon deposits are presented. Deposits were prepared by creating plasma in pure methane. The methane was cracked in RF discharge at the output power of 250 W. The resultant radicals were bonded to the wall of discharge vessel forming a thin film of hydrogenated black carbon with the thickness of about 200nm. The film was then cleaned in situ by oxygen plasma with the density of about 1x10 16 m -3 , electron temperature of 5 eV, neutral gas kinetic temperature of about 100 0 C and neutral atom density of 6x10 21 m -3 . The treatment time was 30 minutes. The efficiency of plasma cleaning was monitored by optical emission spectroscopy. As long as the wall was contaminated with carbon deposit, substantial emission of the CO molecules was detected. As the cleaning was in progress, the CO emission was decreasing and vanished after 30 minutes when the discharge vessel became free of any carbon. The results are explained by interaction of plasma radicals with carbon deposits. (author)

  18. The impact of older person's frailty on the care-related quality of life of their informal caregiver over time: results from the TOPICS-MDS project.

    Science.gov (United States)

    Oldenkamp, Marloes; Hagedoorn, Mariët; Wittek, Rafael; Stolk, Ronald; Smidt, Nynke

    2017-10-01

    To examine the impact of changes in an older person's frailty on the care-related quality of life of their informal caregiver. Five research projects in the TOPICS-MDS database with data of both older person and informal caregiver at baseline and after 12 months follow-up were selected. Frailty was measured in five health domains (functional limitations, psychological well-being, social functioning, health-related quality of life, self-rated health). Care-related quality of life was measured with the Care-Related Quality of Life instrument (CarerQoL-7D), containing two positive (fulfilment, perceived support) and five negative dimensions (relational problems, mental health problems, physical health problems, financial problems, problems combining informal care with daily activities). 660 older person/caregiver couples were included. Older persons were on average 79 (SD 6.9) years of age, and 61% was female. Caregivers were on average 65 (SD 12.6) years of age, and 68% was female. Results of the multivariable linear and logistic regression analyses showed that an increase in older person's frailty over time was related to a lower total care-related quality of life of the caregiver, and to more mental and physical health problems, and problems with combining informal care with daily activities at follow-up. A change in the older person's psychological well-being was most important for the caregiver's care-related quality of life, compared to the other health domains. Health professionals observing decreasing psychological well-being of an older person and increasing hours of informal care provision should be aware of the considerable problems this may bring to their informal caregiver, and should tailor interventions to support informal caregivers according to their specific needs and problems.

  19. High-frequency underwater plasma discharge application in antibacterial activity

    International Nuclear Information System (INIS)

    Ahmed, M. W.; Choi, S.; Lyakhov, K.; Shaislamov, U.; Mongre, R. K.; Jeong, D. K.; Suresh, R.; Lee, H. J.

    2017-01-01

    Plasma discharge is a novel disinfection and effectual inactivation approach to treat microorganisms in aqueous systems. Inactivation of Gram-negative Escherichia coli (E. coli) by generating high-frequency, high-voltage, oxygen (O_2) injected and hydrogen peroxide (H_2O_2) added discharge in water was achieved. The effect of H_2O_2 dose and oxygen injection rate on electrical characteristics of discharge and E. coli disinfection has been reported. Microbial log reduction dependent on H_2O_2 addition with O_2 injection was observed. The time variation of the inactivation efficiency quantified by the log reduction of the initial E. coli population on the basis of optical density measurement was reported. The analysis of emission spectrum recorded after discharge occurrence illustrated the formation of oxidant species (OH"•, H, and O). Interestingly, the results demonstrated that O_2 injected and H_2O_2 added, underwater plasma discharge had fabulous impact on the E. coli sterilization. The oxygen injection notably reduced the voltage needed for generating breakdown in flowing water and escalated the power of discharge pulses. No impact of hydrogen peroxide addition on breakdown voltage was observed. A significant role of oxidant species in bacterial inactivation also has been identified. Furthermore the E. coli survivability in plasma treated water with oxygen injection and hydrogen peroxide addition drastically reduced to zero. The time course study also showed that the retardant effect on E. coli colony multiplication in plasma treated water was favorable, observed after long time. High-frequency underwater plasma discharge based biological applications is technically relevant and would act as baseline data for the development of novel antibacterial processing strategies.

  20. High-frequency underwater plasma discharge application in antibacterial activity

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, M. W.; Choi, S.; Lyakhov, K.; Shaislamov, U. [Jeju National University, Department of Nuclear and Energy Engineering (Korea, Republic of); Mongre, R. K.; Jeong, D. K. [Jeju National University, Faculty of Biotechnology (Korea, Republic of); Suresh, R.; Lee, H. J., E-mail: hjlee@jejunu.ac.kr [Jeju National University, Department of Nuclear and Energy Engineering (Korea, Republic of)

    2017-03-15

    Plasma discharge is a novel disinfection and effectual inactivation approach to treat microorganisms in aqueous systems. Inactivation of Gram-negative Escherichia coli (E. coli) by generating high-frequency, high-voltage, oxygen (O{sub 2}) injected and hydrogen peroxide (H{sub 2}O{sub 2}) added discharge in water was achieved. The effect of H{sub 2}O{sub 2} dose and oxygen injection rate on electrical characteristics of discharge and E. coli disinfection has been reported. Microbial log reduction dependent on H{sub 2}O{sub 2} addition with O{sub 2} injection was observed. The time variation of the inactivation efficiency quantified by the log reduction of the initial E. coli population on the basis of optical density measurement was reported. The analysis of emission spectrum recorded after discharge occurrence illustrated the formation of oxidant species (OH{sup •}, H, and O). Interestingly, the results demonstrated that O{sub 2} injected and H{sub 2}O{sub 2} added, underwater plasma discharge had fabulous impact on the E. coli sterilization. The oxygen injection notably reduced the voltage needed for generating breakdown in flowing water and escalated the power of discharge pulses. No impact of hydrogen peroxide addition on breakdown voltage was observed. A significant role of oxidant species in bacterial inactivation also has been identified. Furthermore the E. coli survivability in plasma treated water with oxygen injection and hydrogen peroxide addition drastically reduced to zero. The time course study also showed that the retardant effect on E. coli colony multiplication in plasma treated water was favorable, observed after long time. High-frequency underwater plasma discharge based biological applications is technically relevant and would act as baseline data for the development of novel antibacterial processing strategies.

  1. Experiments on toroidal inductively coupled alternating-current gas discharges

    International Nuclear Information System (INIS)

    Lok, J.

    1976-01-01

    This report is on an experimental study of a toroidal, inductively coupled a.c. gas discharge sustained at pressures roughly between one tenth of a Torr and some tens of Torrs. After breakdown is obtained at low pressure, additional gas is let in. The energy is inductively coupled into the electrodeless discharge by means of an iron core transformer of which the toroidal plasma column is the secondary winding. The power dissipated in the plasma is between 80 and 260 kW and is delivered by a motor-generator system at a frequency of 8 kHz for times up to 2 seconds. A toroidal magnetic field of 0.5 T maximum can be supplied in a short pulse. Five different gases (hydrogen, deuterium, helium, argon, and nitrogen) are used. The pressure range in which the discharges are sustained is specified, and the dynamic current-voltage characteristics are given for different pressures. Some typical streak pictures with simultaneously obtained recordings of the time behaviour of the discharge current and of the loop voltage are presented for the initial phase - at low pressure - of the discharge. The shape and the position of fully developed discharges at various pressures are discussed on the basis of photographic observations. The temperature of hydrogen plasmas is derived both from the electrical conductivity and from the emission of line radiation. The values of the temperature obtained in these ways differ in magnitude and in time behaviour. A possible explanation of the discrepancy can be obtained in terms of expansion and contraction of electron density and temperature profiles during a period of the discharge current, if it is taken into account that the main part of the light emission always originates from the outer colder regions of the plasma. In a somewhat different pressure regime, this picture is confirmed by microwave measurements

  2. An economically viable alternative to coastal discharge of produced water

    International Nuclear Information System (INIS)

    D'Unger, C.V.; Carr, R.S.; Chapman, D.C.

    1993-01-01

    The discharge of produced waters to coastal estuaries has been common practice on the Texas coast for many years as these discharges are currently exempt from NPDES permitting. A study of the active produced water discharges in Nueces Bay, Texas revealed that all eight effluents were highly toxic as determined by the sea urchin (Arbacia punctulata) fertilization and embryological development assays. An alternative to discharging produced water into coastal estuaries is the use of disposal wells. Inactive wells can be converted to produced water disposal wells. Production records for the Nueces Bay, Texas area reveal that 52% of the gas wells produce less than 100 mcf/d and 50% of the oil wells produce less than 10 b/d. Using conservative estimates, the cost of converting an inactive well to a disposal well was calculated to be $31,500 which could be paid out by a gas well producing as little as 100 mcf/d in 26 months using only 50% of the well's profit. Combining multiple leases to a single disposal well would reduce proportionately the cost to each operation. This study has demonstrated that economically viable disposal options could be achieved in the Nueces Bay area through the imaginative and cooperative formation of produced water disposal ventures. This same model could be applied to produced water discharges in other coastal areas

  3. California study compares natural/drilling discharge contaminants offshore

    International Nuclear Information System (INIS)

    Steinhauer, W.G.; Imamura, E.; Barminski, J.R.; Neff, J.M.

    1992-01-01

    An analysis of drilling fluid and this paper reports that cuttings discharges in the southern Santa Maria basin offshore California indicates that the amount of metal and hydrocarbon contaminants from drilling operations is small relative to that from natural sources. The metal and hydrocarbon discharges were calculated for only one of the three platforms discharging between 1986 and 1989 in the Point Arguello field. However, assuming concentrations are similar on each platform, the combined input of metals and hydrocarbons over the 3-year period was still low (except for barium and lead) compared to the average annual flux from natural sources. The MMS is monitoring the Santa Maria basin to understand possible long-term environmental effects of oil and gas development (California Monitoring Program, Phase II; and Effects of OCS Production Platforms on Rocky Reef Fishes and Fisheries). A site-specific study area was established to determine effects of drilling-related discharges at Chevron U.S.S. Inc.'s platform Hidalgo in the Point Arguello field. Part of the study included review of discharge records for platforms Hidalgo, Hermosa (Chevron), and Harvest (Texaco Exploration and Production Inc.)

  4. Temporal and Geographic variation in the validity and internal consistency of the Nursing Home Resident Assessment Minimum Data Set 2.0.

    Science.gov (United States)

    Mor, Vincent; Intrator, Orna; Unruh, Mark Aaron; Cai, Shubing

    2011-04-15

    The Minimum Data Set (MDS) for nursing home resident assessment has been required in all U.S. nursing homes since 1990 and has been universally computerized since 1998. Initially intended to structure clinical care planning, uses of the MDS expanded to include policy applications such as case-mix reimbursement, quality monitoring and research. The purpose of this paper is to summarize a series of analyses examining the internal consistency and predictive validity of the MDS data as used in the "real world" in all U.S. nursing homes between 1999 and 2007. We used person level linked MDS and Medicare denominator and all institutional claim files including inpatient (hospital and skilled nursing facilities) for all Medicare fee-for-service beneficiaries entering U.S. nursing homes during the period 1999 to 2007. We calculated the sensitivity and positive predictive value (PPV) of diagnoses taken from Medicare hospital claims and from the MDS among all new admissions from hospitals to nursing homes and the internal consistency (alpha reliability) of pairs of items within the MDS that logically should be related. We also tested the internal consistency of commonly used MDS based multi-item scales and examined the predictive validity of an MDS based severity measure viz. one year survival. Finally, we examined the correspondence of the MDS discharge record to hospitalizations and deaths seen in Medicare claims, and the completeness of MDS assessments upon skilled nursing facility (SNF) admission. Each year there were some 800,000 new admissions directly from hospital to US nursing homes and some 900,000 uninterrupted SNF stays. Comparing Medicare enrollment records and claims with MDS records revealed reasonably good correspondence that improved over time (by 2006 only 3% of deaths had no MDS discharge record, only 5% of SNF stays had no MDS, but over 20% of MDS discharges indicating hospitalization had no associated Medicare claim). The PPV and sensitivity levels of

  5. Electronic health records and online medical records: an asset or a liability under current conditions?

    Science.gov (United States)

    Allen-Graham, Judith; Mitchell, Lauren; Heriot, Natalie; Armani, Roksana; Langton, David; Levinson, Michele; Young, Alan; Smith, Julian A; Kotsimbos, Tom; Wilson, John W

    2018-02-01

    Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information. Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital's current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary. Results Of all medical records audited, 82% contained medical and surgical history, allergy information and patient demographics. All audited discharge summaries lacked at least one of the following: demographics, medication allergies, medical and surgical history, medications and adverse drug event information. Only 49% of records audited showed evidence the discharge summary was sent outside the institution. Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services. What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but has since been changed to MyHealth Record (2016). In Victoria, there exists a wide range of electronic health records used to varying degrees, with some hospitals still relying on paper-based records and many using scanned medical records

  6. New discharge tube with virtual cathode

    International Nuclear Information System (INIS)

    Seidelmann, L.; Aubrecht, L.

    2003-01-01

    Till this time known methods of the excitation of the discharge between electrodes are using either secondary or thermo emission of electrons by the cathode. Usually we speak about the self-maintained discharge. Lifetime of the cathode, that is shortened by the emission, limits in principle, the lifetime of the whole discharge tube. The discharge can, according to the present state of the art, be induced also by the inductive way. Arrangement for excitation of such discharge is rather expensive. The construction of the inductive excited discharge tube is considerably influenced by the necessity of the limitation of the losses in excitation magnetic circuits. Especially length of the discharge and pressure of the working gas are limited by the economic standpoints. Function of the discharge is always connected with unwanted electromagnetic radiation, whose restraint is expensive and represents limiting factor for arrangement of the discharge tube (Authors)

  7. Paleofloods records in Himalaya

    Science.gov (United States)

    Srivastava, P.; Kumar, A.; Chaudhary, S.; Meena, N.; Sundriyal, Y. P.; Rawat, S.; Rana, N.; Perumal, R. J.; Bisht, P.; Sharma, D.; Agnihotri, R.; Bagri, D. S.; Juyal, N.; Wasson, R. J.; Ziegler, A. D.

    2017-05-01

    We use paleoflood deposits to reconstruct a record of past floods for the Alaknanda-Mandakini Rivers (Garhwal Himalaya), the Indus River (Ladakh, NW Himalaya) and the Brahmaputra River (NE Himalaya). The deposits are characterized by sand-silt couplets, massive sand beds, and from debris flow sediment. The chronology of paleoflood deposits, established by Optically Stimulated Luminescence (OSL) and 14C AMS dating techniques, indicates the following: (i) The Alaknanda-Mandakini Rivers experienced large floods during the wet and warm Medieval Climate Anomaly (MCA); (ii) the Indus River experienced at least 14 large floods during the Holocene climatic optimum, when flood discharges were likely an order of magnitude higher than those of modern floods; and (iii) the Brahmaputra River experienced a megaflood between 8 and 6 ka. Magnetic susceptibility of flood sediments indicates that 10 out of 14 floods on the Indus River originated in the catchments draining the Ladakh Batholith, indicating the potential role of glacial lake outbursts (GLOFs) and/or landslide lake outbursts (LLOFs) in compounding flood magnitudes. Pollen recovered from debris flow deposits located in the headwaters of the Mandakini River showed the presence of warmth-loving trees and marshy taxa, thereby corroborating the finding that floods occurred during relatively warm periods. Collectively, our new data indicate that floods in the Himalaya largely occur during warm and wet climatic phases. Further, the evidence supports the notion that the Indian Summer Monsoon front may have penetrated into the Ladakh area during the Holocene climatic optimum.

  8. Feasibility of wear compensation in micro EDM milling based on discharge counting and discharge population characterization

    DEFF Research Database (Denmark)

    Bissacco, Giuliano; Hansen, Hans Nørgaard; Tristo, G.

    2011-01-01

    This paper investigates the applicability of real time wear compensation in micro EDM milling based on discharge counting and discharge population characterization. Experiments were performed involving discharge counting and tool electrode wear measurement in a wide range of process parameters...

  9. Relativistic Electrons in Electric Discharges

    DEFF Research Database (Denmark)

    Cinar, Deniz

    at the time when also gigantic electric discharges were observed at 10-90 km altitude in the stratosphere and mesosphere, the so called “jets” and “sprites”, commonly referred to as “Transient Luminous Events” (TLEs). TGFs were _rst thought connected to TLEs, but later research has pointed to lightning......Thunderstorms generate bursts of X- and Gamma radiation. When observed from spacecraft, the bursts are referred to as “Terrestrial Gamma-ray Flashes” (TGFs). They are bremsstrahlung from energetic electrons accelerated in thunderstorm electric _elds. The TGFs were _rst observed in the 90ties...... discharges as the source. The “Atmosphere-Space Interactions Monitor” (ASIM) for the International Space Station in 2016, led by DTU Space, and the French microsatellite TARANIS, also with launch in 2016, will identify with certainty the source of TGFs. In preparation for the missions, the Ph.D. project has...

  10. Runaway electrons in toroidal discharges

    International Nuclear Information System (INIS)

    Knoepfel, H.

    1979-01-01

    Experimental and theoretical studies of runaway electrons in toroidal devices are reviewed here, with particular reference to tokamaks. The complex phenomenology of runaway effects, which have been the subject of research for the past twenty years, is organized within the framework of a number of physical models. The mechanisms and rates for runaway production are discussed first, followed by sections on runaway-driven kinetic relaxation processes and runaway orbit confinement. Next, the equilibrium and stability of runaway-dominated discharges are reviewed. Models for runaway production at early times in the discharge and the scaling of runaway phenomena to larger devices are also discussed. Finally, detection techniques and possible applications of runaways are mentioned. (author)

  11. Energy discharge heater power supply

    International Nuclear Information System (INIS)

    Jaskierny, W.

    1992-11-01

    The heater power supply is intended to supply capacitively stored,energy to embedded heater strips in cryo magnets. The amount of energy can be controlled by setting different charge different capacitor values. Two chassis' can be operated in series or interlocks are provided. The charge voltage, number of capacitors pulse can be monitored. There and dual channel has two discharge supplies in one chassis. This report reviews the characteristics of this power supply further

  12. Electrostatic probes in luminescent discharges

    International Nuclear Information System (INIS)

    Cunha Raposo, C. da.

    1980-01-01

    A system to produce luminescent type plasma by continuos discharge and ionization by high frequency was constructed. The ionization was done in the air and in the argon under pressures from 3 to 10 mmHg. The parameters of a non magnetized collisional plasma and the parameters of a magnetized plasma such as, density, eletron temperature and potential, using a Langmuir probe with plane geometry, were determined. (M.C.K.) [pt

  13. Pediatric cardiac surgery Parent Education Discharge Instruction (PEDI) program: a pilot study.

    Science.gov (United States)

    Staveski, Sandra L; Zhelva, Bistra; Paul, Reena; Conway, Rosalind; Carlson, Anna; Soma, Gouthami; Kools, Susan; Franck, Linda S

    2015-01-01

    In developing countries, more children with complex cardiac defects now receive treatment for their condition. For successful long-term outcomes, children also need skilled care at home after discharge. The Parent Education Discharge Instruction (PEDI) program was developed to educate nurses on the importance of discharge teaching and to provide them with a structured process for conducting parent teaching for home care of children after cardiac surgery. The aim of this pilot study was to generate preliminary data on the feasibility and acceptability of the nurse-led structured discharge program on an Indian pediatric cardiac surgery unit. A pre-/post-design was used. Questionnaires were used to evaluate role acceptability, nurse and parent knowledge of discharge content, and utility of training materials with 40 nurses and 20 parents. Retrospective audits of 50 patient medical records (25 pre and 25 post) were performed to evaluate discharge teaching documentation. Nurses' discharge knowledge increased from a mean of 81% to 96% (P = .001) after participation in the training. Nurses and parents reported high levels of satisfaction with the education materials (3.75-4 on a 4.00-point scale). Evidence of discharge teaching documentation in patient medical records improved from 48% (12 of 25 medical records) to 96% (24 of 25 medical records) six months after the implementation of the PEDI program. The structured nurse-led parent discharge teaching program demonstrated feasibility, acceptability, utility, and sustainability in the cardiac unit. Future studies are needed to examine nurse, parent, child, and organizational outcomes related to this expanded nursing role in resource-constrained environments. © The Author(s) 2014.

  14. Records Management Directive

    Data.gov (United States)

    Office of Personnel Management — The Office of Personnel Management (OPM) Records Management Directive provides guidelines for the management of OPM records, and identifies the records management...

  15. Aplastic Anemia & MDS International Foundation

    Science.gov (United States)

    ... States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia ... in Corporate Sponsorship Financials Code of Ethics Operating Policies

  16. Internal Electrostatic Discharge Monitor - IESDM

    Science.gov (United States)

    Kim, Wousik; Goebel, Dan M.; Jun, Insoo; Garrett, Henry B.

    2011-01-01

    A document discusses an innovation designed to effectively monitor dielectric charging in spacecraft components to measure the potential for discharge in order to prevent damage from internal electrostatic discharge (IESD). High-energy electrons penetrate the structural materials and shielding of a spacecraft and then stop inside dielectrics and keep accumulating. Those deposited charges generate an electric field. If the electric field becomes higher than the breakdown threshold (approx. =2 x 10(exp 5) V/cm), discharge occurs. This monitor measures potentials as a function of dielectric depth. Differentiation of potential with respect to the depth yields electric field. Direct measurement of the depth profile of the potential in a dielectric makes real-time electronic field evaluation possible without simulations. The IESDM has been designed to emulate a multi-layer circuit board, to insert very thin metallic layers between the dielectric layers. The conductors serve as diagnostic monitoring locations to measure the deposited electron-charge and the charge dynamics. Measurement of the time-dependent potential of the metal layers provides information on the amount of charge deposited in the dielectrics and the movement of that charge with time (dynamics).

  17. Leaving the hospital - your discharge plan

    Science.gov (United States)

    ... patientinstructions/000867.htm Leaving the hospital - your discharge plan To use the sharing features on this page, ... once you leave. This is called a discharge plan. Your health care providers at the hospital will ...

  18. EPA Region 1 No Discharge Zones

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset details No Discharge Zones (NDZ) for New England. Boaters may not discharge waste into these areas. Boundaries were determined mostly by Federal...

  19. Early hospital discharge and early puerperal complications.

    Science.gov (United States)

    Ramírez-Villalobos, Dolores; Hernández-Garduño, Adolfo; Salinas, Aarón; González, Dolores; Walker, Dilys; Rojo-Herrera, Guadalupe; Hernández-Prado, Bernardo

    2009-01-01

    To evaluate the association between time of postpartum discharge and symptoms indicative of complications during the first postpartum week. Women with vaginal delivery at a Mexico City public hospital, without complications before the hospital discharge, were interviewed seven days after delivery. Time of postpartum discharge was classified as early (25 hours). The dependent variable was defined as the occurrence and severity of puerperal complication symptoms. Out of 303 women, 208 (68%) were discharged early. However, women with early discharge and satisfactory prenatal care had lower odds of presenting symptoms in early puerperium than women without early discharge and inadequate prenatal care (OR 0.36; 95% confidence intervals = 0.17-0.76). There was no association between early discharge and symptoms of complications during the first postpartum week; the odds of complications were lower for mothers with early discharge and satisfactory prenatal care.

  20. Early discharge hospital at home.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha

    2017-06-26

    Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit. We searched clinical trials registries. Randomised trials comparing early discharge hospital at home with acute hospital inpatient care for adults. We excluded obstetric, paediatric and mental health hospital at home schemes.   DATA COLLECTION AND ANALYSIS: We followed the standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 32 trials (N = 4746), six of them new for this update, mainly conducted in high-income countries. We judged most of the studies to have a low or unclear risk of bias. The intervention was delivered by hospital outreach services (17 trials), community-based services (11 trials), and was co-ordinated by a hospital-based stroke team or physician in conjunction with community-based services in four trials.Studies recruiting people recovering from strokeEarly discharge hospital at home probably makes little or no difference to mortality at three to six months (risk ratio (RR) 0.92, 95% confidence interval (CI) 0.57 to 1.48, N = 1114, 11 trials, moderate-certainty evidence) and may make little or no difference to the risk of hospital readmission (RR 1.09, 95% CI 0.71 to 1.66, N = 345, 5 trials, low-certainty evidence). Hospital at home may lower the risk of living in institutional setting at six months (RR 0.63, 96% CI

  1. Capacitor discharges, magnetohydrodynamics, X-rays, ultrasonics

    CERN Document Server

    Früngel, Frank B A

    1965-01-01

    High Speed Pulse Technology, Volume 1: Capacitor Discharges - Magnetohydrodynamics - X-Rays - Ultrasonics deals with the theoretical and engineering problems that arise in the capacitor discharge technique.This book discusses the characteristics of dielectric material, symmetrical switch tubes with mercury filling, and compensation conductor forms. The transformed discharge for highest current peaks, ignition transformer for internal combustion engines, and X-ray irradiation of subjects in mechanical motion are also elaborated. This text likewise covers the transformed capacitor discharge in w

  2. Basic Studies of Distributed Discharge Limiters

    Science.gov (United States)

    2014-02-10

    electron avalanche ionization discharges induced by a focused 110 GHz millimeter-wave beam in atmospheric air. Discharges take place in a free volume of...plasma. 3.1.7 Vacuum Ultraviolet emission from pulsed discharges at atmospheric pressure. Fig. 6. Energy level diagram for molecular and...the utilized spectral simulation software, SPECTRAPLOT. 3.1.8 Non-intrusive diagnostic method for dissociation degree in pulsed discharges

  3. Validation of the Care-Related Quality of Life Instrument in different study settings: findings from The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS).

    Science.gov (United States)

    Lutomski, J E; van Exel, N J A; Kempen, G I J M; Moll van Charante, E P; den Elzen, W P J; Jansen, A P D; Krabbe, P F M; Steunenberg, B; Steyerberg, E W; Olde Rikkert, M G M; Melis, R J F

    2015-05-01

    Validity is a contextual aspect of a scale which may differ across sample populations and study protocols. The objective of our study was to validate the Care-Related Quality of Life Instrument (CarerQol) across two different study design features, sampling framework (general population vs. different care settings) and survey mode (interview vs. written questionnaire). Data were extracted from The Older Persons and Informal Caregivers Minimum DataSet (TOPICS-MDS, www.topics-mds.eu ), a pooled public-access data set with information on >3,000 informal caregivers throughout the Netherlands. Meta-correlations and linear mixed models between the CarerQol's seven dimensions (CarerQol-7D) and caregiver's level of happiness (CarerQol-VAS) and self-rated burden (SRB) were performed. The CarerQol-7D dimensions were correlated to the CarerQol-VAS and SRB in the pooled data set and the subgroups. The strength of correlations between CarerQol-7D dimensions and SRB was weaker among caregivers who were interviewed versus those who completed a written questionnaire. The directionality of associations between the CarerQol-VAS, SRB and the CarerQol-7D dimensions in the multivariate model supported the construct validity of the CarerQol in the pooled population. Significant interaction terms were observed in several dimensions of the CarerQol-7D across sampling frame and survey mode, suggesting meaningful differences in reporting levels. Although good scientific practice emphasises the importance of re-evaluating instrument properties in individual research studies, our findings support the validity and applicability of the CarerQol instrument in a variety of settings. Due to minor differential reporting, pooling CarerQol data collected using mixed administration modes should be interpreted with caution; for TOPICS-MDS, meta-analytic techniques may be warranted.

  4. Radio frequency discharge with dust particles

    NARCIS (Netherlands)

    Chutov, Y. I.; W. J. Goedheer,; Kravchenko, O. Y.; Zuz, V. M.; Yan, M.; Martins, R.; Ferreira, I.; Fortunato, E.; Kroesen, G.

    2000-01-01

    A 1D PIC/MCC method has been developed for computer simulations of low-pressure RF discharges with dust particles using the method for dust-free discharges. A RF discharge in argon with dust particles distributed uniformly in the interelectrode gap is simulated at parameters providing a possibility

  5. 32 CFR 724.117 - Discharge review.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Discharge review. 724.117 Section 724.117 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NAVAL DISCHARGE REVIEW BOARD Definitions § 724.117 Discharge review. A nonadversary administrative reappraisal at the level of...

  6. Expansion of a nitrogen discharge by sound

    International Nuclear Information System (INIS)

    Antinyan, M.A.; Galechyan, G.A.; Tavakalyan, L.B.

    1992-01-01

    When the background pressure and the discharge current in a gas discharge are raised the plasma column is tightened up into a filament. Then the discharge occupies a region of the discharge tube whose transverse dimensions are substantially less than those of the tube. This contraction phenomenon in discharges restricts the range of parameters used in various devices to the range of relatively low discharge currents and low gas pressures. This contraction interferes with creating high-power gas lasers, since it acts destructively on the lasing process. In order to suppress filamentation of discharges the working gas has been pumped through the system at high speed, with considerable success. The turbulent mixing in the stream plays an important role in creating an uncontracted discharge at high pressures. The purpose of the present work is to study the possibility of undoing the contraction of a nitrogen discharge, which is one of the main components in the operation of a CO 2 laser, by introducing an intense sound wave in the discharge tube. Discharge contraction and the effect of a sound wave propagating along the plasma column have been investigated experimentally in nitrogen by studying the current-voltage characteristics of a contracted discharge. 6 refs., 3 figs

  7. On regulation of radioactive airborne discharge

    International Nuclear Information System (INIS)

    Stroganov, A.A.; Kuryndin, A.V.; Shapovalov, A.S.; Orlov, M.Yu.

    2013-01-01

    Authors present the Russian regulatory basis of radioactive airborne discharges which was updated after enactment of the Methodology for airborne discharge limits development. Criteria for establishing of airborne discharge limits, scope and other features of methodology are also considered in the article [ru

  8. The role of discharge variability in the formation and preservation of alluvial sediment bodies

    Science.gov (United States)

    Fielding, Christopher R.; Alexander, Jan; Allen, Jonathan P.

    2018-03-01

    Extant, planform-based facies models for alluvial deposits are not fully fit for purpose, because they over-emphasise plan form whereas there is little in the alluvial rock record that is distinctive of any particular planform, and because the planform of individual rivers vary in both time and space. Accordingly, existing facies models have limited predictive capability. In this paper, we explore the role of inter-annual peak discharge variability as a possible control on the character of the preserved alluvial record. Data from a suite of modern rivers, for which long-term gauging records are available, and for which there are published descriptions of subsurface sedimentary architecture, are analysed. The selected rivers are categorized according to their variance in peak discharge or the coefficient of variation (CVQp = standard deviation of the annual peak flood discharge over the mean annual peak flood discharge). This parameter ranges over the rivers studied between 0.18 and 1.22, allowing classification of rivers as having very low ( 0.90) annual peak discharge variance. Deposits of rivers with very low and low peak discharge variability are dominated by cross-bedding on various scales and preserve macroform bedding structure, allowing the interpretation of bar construction processes. Rivers with moderate values preserve mostly cross-bedding, but records of macroform processes are in places muted and considerably modified by reworking. Rivers with high and very high values of annual peak discharge variability show a wide range of bedding structures commonly including critical and supercritical flow structures, abundant in situ trees and transported large, woody debris, and their deposits contain pedogenically modified mud partings and generally lack macroform structure. Such a facies assemblage is distinctively different from the conventional fluvial style recorded in published facies models but is widely developed both in modern and ancient alluvial

  9. Narrow gap electronegative capacitive discharges

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, E.; Lieberman, M. A.; Lichtenberg, A. J. [Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California 94720 (United States)

    2013-10-15

    Narrow gap electronegative (EN) capacitive discharges are widely used in industry and have unique features not found in conventional discharges. In this paper, plasma parameters are determined over a range of decreasing gap length L from values for which an electropositive (EP) edge exists (2-region case) to smaller L-values for which the EN region connects directly to the sheath (1-region case). Parametric studies are performed at applied voltage V{sub rf}=500 V for pressures of 10, 25, 50, and 100 mTorr, and additionally at 50 mTorr for 1000 and 2000 V. Numerical results are given for a parallel plate oxygen discharge using a planar 1D3v (1 spatial dimension, 3 velocity components) particle-in-cell (PIC) code. New interesting phenomena are found for the case in which an EP edge does not exist. This 1-region case has not previously been investigated in detail, either numerically or analytically. In particular, attachment in the sheaths is important, and the central electron density n{sub e0} is depressed below the density n{sub esh} at the sheath edge. The sheath oscillations also extend into the EN core, creating an edge region lying within the sheath and not characterized by the standard diffusion in an EN plasma. An analytical model is developed using minimal inputs from the PIC results, and compared to the PIC results for a base case at V{sub rf}=500 V and 50 mTorr, showing good agreement. Selected comparisons are made at the other voltages and pressures. A self-consistent model is also developed and compared to the PIC results, giving reasonable agreement.

  10. Mozart K.448 and epileptiform discharges: effect of ratio of lower to higher harmonics.

    Science.gov (United States)

    Lin, Lung-Chang; Lee, Wei-Te; Wu, Hui-Chuan; Tsai, Chin-Lin; Wei, Ruey-Chang; Jong, Yuh-Jyh; Yang, Rei-Cheng

    2010-05-01

    Certain music has been shown to improve mental function, leading to what is known as the Mozart effect. This study measured the impact of Mozart's Sonata for two pianos in D major, K.448, on different epileptic foci of epileptiform discharge in Taiwanese children (n=58) with seizure disorders and investigated the characteristics of the musical stimulus presented that resulted in epileptiform discharge reduction. We examined the relationship between the number of discharges with the foci of epileptiform discharge (n=6), sleep state, gender, and mentality. A continuous electroencephalogram was recorded before, during and after exposure to Mozart's Sonata for two pianos in D major, K.448 (piano K.448), and the frequencies of discharges were compared. The study was repeated a week later using digitally computerized string version of the same musical stimulus (string K.448), in patients who responded to piano K.448 with the largest reduction in interictal discharges (n=11). Interictal discharges were reduced in most (81.0%) patients and varied greatly (33.10+/-28.33%) as they listened to the piano K.448 (more fundamental tones and lower harmonics). Patients with generalized or central discharge showed the most improvement. In most patients (76.1%), the decrease in epileptiform discharges continued after the music ended. The state of wakefulness, gender and mentality did not affect the results. Although the string K.448 had a larger number of higher harmonics in the spectrogram analysis, the discharges were not reduced at all when listening to this music. These results suggest that listening to Mozart K.448 for two pianos reduced epileptiform discharges in children with epilepsy. This study suggests that it is possible to reduce the number of epileptiform discharges in some patients by optimizing the fundamental tones and minimizing the higher frequency harmonics. Copyright 2010 Elsevier B.V. All rights reserved.

  11. Double discharges in unipolar-pulsed dielectric barrier discharge xenon excimer lamps

    International Nuclear Information System (INIS)

    Liu Shuhai; Neiger, Manfred

    2003-01-01

    Excitation of dielectric barrier discharge xenon excimer lamps by unipolar short square pulses is studied in this paper. Two discharges with different polarity are excited by each voltage pulse (double discharge phenomenon). The primary discharge occurs at the top or at the rising flank of the applied unipolar square pulse, which is directly energized by the external circuit. The secondary discharge with the reversed polarity occurs at the falling flank or shortly after the falling flank end (zero external voltage) depending on the pulse width, which is energized by the energy stored by memory charges deposited by the primary discharge. Fast-speed ICCD imaging shows the primary discharge has a conic discharge appearance with a channel broadening on the anode side. This channel broadening increases with increasing the pulse top level. Only the anode-side surface discharge is observed in the primary discharge. The surface discharge on the cathode side which is present in bipolar sine voltage excitation is not observed. On the contrary, the secondary discharge has only the cathode-side surface discharge. The surface discharge on the anode side is not observed. The secondary discharge is much more diffuse than the primary discharge. Time-resolved emission measurement of double discharges show the secondary discharge emits more VUV xenon excimer radiation but less infrared (IR) xenon atomic emission than the primary discharge. It was found that the IR xenon atomic emission from the secondary discharge can be reduced by shortening the pulse width. The energy efficiency of unipolar-pulsed xenon excimer lamps (the overall energy efficiency of double discharges) is much higher than that obtained under bipolar sine wave excitation. The output VUV spectrum under unipolar pulse excitation is found to be identical to that under sine wave excitation and independent of injected electric power

  12. State waste discharge permit application for cooling water and condensate discharges

    Energy Technology Data Exchange (ETDEWEB)

    Haggard, R.D.

    1996-08-12

    The following presents the Categorical State Waste Discharge Permit (SWDP) Application for the Cooling Water and Condensate Discharges on the Hanford Site. This application is intended to cover existing cooling water and condensate discharges as well as similar future discharges meeting the criteria set forth in this document.

  13. Simultaneous measurement of ignition energy and current signature for brush discharges

    International Nuclear Information System (INIS)

    Fast, Lars; Andersson, Birgitta; Smallwood, Jeremy; Holdstock, Paul; Paasi, Jaakko

    2011-01-01

    Accurate prediction of the probability of ignition arising from charged insulators is a crucial element of risk assessment in process industry. Incendiary brush discharges can occur when a large or grounded conductor approaches a charged insulator in the presence of a flammable atmosphere. This paper describes ignition tests based on an IEC standard method and simultaneously recorded temporal distribution of current released in the discharges, using a discharge probe integrated with the ignition probe. Ignition and non-ignition results are compared with peak discharge current and charge transferred in the discharge. No clear ignition threshold was found for either of these parameters. No major differences were found between igniting and non-igniting waveforms.

  14. Sustained diffusive alternating current gliding arc discharge in atmospheric pressure air

    Science.gov (United States)

    Zhu, Jiajian; Gao, Jinlong; Li, Zhongshan; Ehn, Andreas; Aldén, Marcus; Larsson, Anders; Kusano, Yukihiro

    2014-12-01

    Rapid transition from glow discharge to thermal arc has been a common problem in generating stable high-power non-thermal plasmas especially at ambient conditions. A sustained diffusive gliding arc discharge was generated in a large volume in atmospheric pressure air, driven by an alternating current (AC) power source. The plasma column extended beyond the water-cooled stainless steel electrodes and was stabilized by matching the flow speed of the turbulent air jet with the rated output power. Comprehensive investigations were performed using high-speed movies measured over the plasma column, synchronized with simultaneously recorded current and voltage waveforms. Dynamic details of the novel non-equilibrium discharge are revealed, which is characterized by a sinusoidal current waveform with amplitude stabilized at around 200 mA intermediate between thermal arc and glow discharge, shedding light to the governing mechanism of the sustained spark-suppressed AC gliding arc discharge.

  15. Methods to estimate annual mean spring discharge to the Snake River between Milner Dam and King Hill, Idaho

    Science.gov (United States)

    Kjelstrom, L.C.

    1995-01-01

    Many individual springs and groups of springs discharge water from volcanic rocks that form the north canyon wall of the Snake River between Milner Dam and King Hill. Previous estimates of annual mean discharge from these springs have been used to understand the hydrology of the eastern part of the Snake River Plain. Four methods that were used in previous studies or developed to estimate annual mean discharge since 1902 were (1) water-budget analysis of the Snake River; (2) correlation of water-budget estimates with discharge from 10 index springs; (3) determination of the combined discharge from individual springs or groups of springs by using annual discharge measurements of 8 springs, gaging-station records of 4 springs and 3 sites on the Malad River, and regression equations developed from 5 of the measured springs; and (4) a single regression equation that correlates gaging-station records of 2 springs with historical water-budget estimates. Comparisons made among the four methods of estimating annual mean spring discharges from 1951 to 1959 and 1963 to 1980 indicated that differences were about equivalent to a measurement error of 2 to 3 percent. The method that best demonstrates the response of annual mean spring discharge to changes in ground-water recharge and discharge is method 3, which combines the measurements and regression estimates of discharge from individual springs.

  16. Discharge residence of TLD tagged fish

    International Nuclear Information System (INIS)

    Romberg, G.P.; Prepejchal, W.

    1974-01-01

    Although visual observations suggested that fish remained in the discharge for considerable periods, temperature-sensitive tags indicated the majority of fish spend less than 50 hr or 10 percent of the time at discharge temperatures. During 1974 a second fish tagging study was conducted, using temperature-sensitive tags to yield discharge residence times of Lake Michigan salmonids at Point Beach thermal discharge. Preliminary results revealed that many fish tag values were close to Unit I line indicating that calculated maximum discharge residence times for these fish will be nearly 100 percent of the elapsed time

  17. Long recovery VLF perturbations associated with lightning discharges

    Science.gov (United States)

    Salut, M. M.; Abdullah, M.; Graf, K. L.; Cohen, M. B.; Cotts, B. R. T.; Kumar, Sushil

    2012-08-01

    Long D-region ionospheric recovery perturbations are a recently discovered and poorly understood subcategory of early VLF events, distinguished by exceptionally long ionospheric recovery times of up to 20 min (compared to more typical ˜1 min recovery times). Characteristics and occurrence rates of long ionospheric recovery events on the NWC transmitter signal recorded at Malaysia are presented. 48 long recovery events were observed. The location of the causative lightning discharge for each event is determined from GLD360 and WWLLN data, and each discharge is categorized as being over land or sea. Results provide strong evidence that long recovery events are attributed predominately to lightning discharges occurring over the sea, despite the fact that lightning activity in the region is more prevalent over land. Of the 48 long recovery events, 42 were attributed to lightning activity over water. Analysis of the causative lightning of long recovery events in comparison to all early VLF events reveals that these long recovery events are detectable for lighting discharges at larger distances from the signal path, indicating a different scattering pattern for long recovery events.

  18. Prepubertal vaginal discharge: Vaginoscopy to rule out foreign body.

    Science.gov (United States)

    Ekinci, Saniye; Karnak, İbrahim; Tanyel, Feridun Cahit; Çiftçi, Arbay Özden

    2016-01-01

    Medical records of all prepubertal patients who underwent vaginoscopy to rule out vaginal foreign body between 2004 and 2013 were reviewed retrospectively. All patients were evaluated by pediatricians prior to surgical consultation. Vaginoscopy is performed in the operating room under general anesthesia. During the study period, 20 girls with persistent vaginal discharge with a mean age of 6.8 years (1-13 years) underwent vaginoscopy to rule out vaginal foreign body. Six patients had bloody vaginal discharge and 4 had recurrent vaginal bleeding lasting for more than one month. Ten patients had purulent vaginal discharge lasting for 1-7 months. None of vaginal cultures revealed pathological bacteria or candida species. Preoperative imaging techniques revealed vaginal foreign body in one patient only. Vaginoscopy demonstrated vaginal foreign bodies in four patients. Foreign bodies were grass inflorescence, safety pin and undefined brownish particles (n=2), which may be pieces of toilet paper or feces. There was no complication related to vaginoscopy and removal of foreign body. Hymen integrity was preserved in all patients. Persistent or recurrent vaginal discharge in prepubertal girls should raise the suspect of vaginal foreign body. Continuous flow vaginoscopy is mandatory to detect and remove any vaginal foreign body. Early diagnosis would prevent complications secondary to long-standing foreign bodies.

  19. High speed photography for investigating kiloampere discharges in supersonic air flows

    International Nuclear Information System (INIS)

    Jones, G.R.; Strachan, D.

    1975-01-01

    Examples of the use of conventional high speed photographic techniques are given for obtaining information about the behaviour of high current arc discharges in different gas flow fields. The photographic records yield information about the extent of both the luminous arc core and the surrounding heated volume of gas. A knowledge of these parameters leads to a better understanding of arc discharges which occur in gas blast circuit breakers. (author)

  20. [Severe vaginal discharge following rectal surgery].

    Science.gov (United States)

    Burg, L C; Bremers, A J A; Heesakkers, J P F A; Kluivers, K B

    2018-01-01

    Almost 50% of women who have had rectal surgery subsequently develop vaginal discharge. Due to the recurrent and unexpected nature of this heavy discharge, they often experience it as very distressing. Many of these women undergo extensive diagnostic tests that are mainly focused on identifying fistula formation. If no fistula is found, in most cases no other cause for severe vaginal discharge can be demonstrated. In our practice, we saw three patients (49-, 54- and 74-years-old, respectively) with similar severe vaginal discharge after rectal surgery and in whom no explanation for the vaginal discharge could be found. For this reason we conducted a literature search into this condition. Anatomical changes appear to be responsible for heavy vaginal discharge following rectal surgery. Changes in pelvic floor muscles and compression of the distal part of the vagina may lead to pooling of fluid in the proximal part of the vagina, resulting in severe discharge. Symptomatic treatment may reduce the symptoms.

  1. Anisotropic Percolation Analysis of Discharge

    Science.gov (United States)

    Matsumoto, Shogo; Odagaki, Takashi

    2014-03-01

    Exploiting a nonlinear resistor network on a square lattice in two dimensions, we investigate discharge when two opposite sides of the lattice are subjected to a constant voltage difference. Each site is ionized randomly with a probability in proportion to the square of the strength of the electric field, and the resistivity between two ionized sites is assumed to be 10-6 times smaller than the original resistivity. Using Monte Carlo simulation, we obtain the current and distribution of clusters of ionized sites as functions of the fraction of ionized sites. It is found that a wall of potential drop is formed as the fraction approaches a critical value, which is followed by discharge. The critical value is much smaller than the critical percolation probability of the standard site percolation on the square lattice. We also find that a singular behavior of the cluster distribution is expected at a critical fraction differently from that for the current, and that the critical exponents characterizing the cluster distribution satisfy the scaling relation known for two-dimensional percolation, while the critical exponent of the percolation probability is close to the value reported for a directed percolation.

  2. Electrostatic discharge concepts and definitions

    Energy Technology Data Exchange (ETDEWEB)

    Borovina, Dan L [Los Alamos National Laboratory

    2008-01-01

    Many objects -like a human body, plastic wrap, or a rolling cart -that are electrically neutral, overall, can gain a net electrostatic charge by means of one of three methods: induction, physical transfer, or triboelectric charging (separation of conductive surfaces). The result is a voltage difference between the charged object and other objects, creating a situation where current flow is likely if two objects come into contact or close proximity. This current flow is known as electrostatic discharge, or ESD. The energy and voltage of the discharge can be influenced by factors such as the temperature and humidity in the room, the types of materials or flooring involved, or the clothing and footwear a person uses. Given the possible ranges of the current and voltage characteristic of an ESD pulse, it is important to consider the safety risks associated with detonator handling, assembly and disassembly, transportation and maintenance. For main charge detonators, these safety risks include high explosive violent reactions (HEVR) as well as inadvertent nuclear detonations (lND).

  3. Body temperatures of fish feeding in the Point Beach thermal discharge

    International Nuclear Information System (INIS)

    Spigarelli, S.A.; Thommes, M.M.

    1974-01-01

    Between April and November, 1973, measurements of internal body temperature were made on 1310 fish caught by fishermen at the Point Beach Nuclear Plant. Records were also made of fish weight, length, and sex and intake and discharge temperatures. A table is presented to show mean monthly body temperatures and numbers of each species. Approximately 76 percent of the measurements were made on rainbow and brown trout, since these species accounted for 74 percent of the catch. Body temperatures of most fish were intermediate between intake and discharge temperatures. Results suggested that each species has rather specific seasonal temperature requirements and that the maximum discharge temperature was normally avoided by feeding fish

  4. Time-Varying Networks of Inter-Ictal Discharging Reveal Epileptogenic Zone.

    Science.gov (United States)

    Zhang, Luyan; Liang, Yi; Li, Fali; Sun, Hongbin; Peng, Wenjing; Du, Peishan; Si, Yajing; Song, Limeng; Yu, Liang; Xu, Peng

    2017-01-01

    The neuronal synchronous discharging may cause an epileptic seizure. Currently, most of the studies conducted to investigate the mechanism of epilepsy are based on EEGs or functional magnetic resonance imaging (fMRI) recorded during the ictal discharging or the resting-state, and few studies have probed into the dynamic patterns during the inter-ictal discharging that are much easier to record in clinical applications. Here, we propose a time-varying network analysis based on adaptive directed transfer function to uncover the dynamic brain network patterns during the inter-ictal discharging. In addition, an algorithm based on the time-varying outflow of information derived from the network analysis is developed to detect the epileptogenic zone. The analysis performed revealed the time-varying network patterns during different stages of inter-ictal discharging; the epileptogenic zone was activated prior to the discharge onset then worked as the source to propagate the activity to other brain regions. Consistence between the epileptogenic zones detected by our proposed approach and the actual epileptogenic zones proved that time-varying network analysis could not only reveal the underlying neural mechanism of epilepsy, but also function as a useful tool in detecting the epileptogenic zone based on the EEGs in the inter-ictal discharging.

  5. Quality assurance records and records' system

    International Nuclear Information System (INIS)

    Link, M.; Martinek, J.

    1980-01-01

    For nuclear power plants extensive proof of quality is required which has to be documented reliably by quality records. With respect to the paper volume it is the most comprehensive 'curriculum vitae' of the technique. Traditional methods of information and recording are unsatisfactory for meeting regulatory requirements for maintaining the QA-aspects of status reporting, completeness, traceability and retrieval. Therefore KWU has established a record (documentation) subsystem within the overall component qualification system. Examples of the general documentation requirements, the procedure and handling in accordance with this subsystem for mechanical equipment are to be described examplarily. Topics are: - National and international requirements - Definition of QA records - Modular and product orientated KWU-record subsystem - Criteria for developing records - Record control, distribution, collection, storage - New documentation techniques (microfilm, data processing) - Education and training of personnel. (orig./RW)

  6. Microsecond-scale electric field pulses in cloud lightning discharges

    Science.gov (United States)

    Villanueva, Y.; Rakov, V. A.; Uman, M. A.; Brook, M.

    1994-01-01

    From wideband electric field records acquired using a 12-bit digitizing system with a 500-ns sampling interval, microsecond-scale pulses in different stages of cloud flashes in Florida and New Mexico are analyzed. Pulse occurrence statistics and waveshape characteristics are presented. The larger pulses tend to occur early in the flash, confirming the results of Bils et al. (1988) and in contrast with the three-stage representation of cloud-discharge electric fields suggested by Kitagawa and Brook (1960). Possible explanations for the discrepancy are discussed. The tendency for the larger pulses to occur early in the cloud flash suggests that they are related to the initial in-cloud channel formation processes and contradicts the common view found in the atmospheric radio-noise literature that the main sources of VLF/LF electromagnetic radiation in cloud flashes are the K processes which occur in the final, or J type, part of the cloud discharge.

  7. Galactography in non-lactating nipple discharge

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Myung Ok; Lee, Joo Mi; Moon, Jang Ho; Kang, Ik Won; Chung, Soo Young; Bae, Sang Hoon; Park, Soo Sung [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1988-08-15

    Nipple discharge in non-lactating breast is classified as 2 groups. The first group is stagnation discharge which is determined by an apocrino-like exfoliation and stagnation within the ductal system. The second group is hyperplastic or neoplastic group. The secretory breast disease combined with nipple discharge can not be diagnosed by simple X-ray mammography of ultrasonography. For differential diagnosis of secretory breast disease and for localization of lesions, the galactography is necessary. We analysed 49 cases of galactography is non-lactating breat and obtained following results. 1. The most common cause of discharge was duct ectasis (39%) in stagnation discharge group and papilloma (23%) in hyperplastic discharge group. 2. Hyperplastic discharge group occurred most frequently in 5th decade of age and was discovered more frequently in fatty parenchymal pattern on simple mammography. 3. The most frequent type of nipple discharge was cloudy-milky type in stagnation group and bloody nature in hyperplastic group. 4. The most common cause of bloody discharge was papilloma (58%). 5. The bloody nipple discharge among 56 cases of breast cancer during 4 years occurred only in 5 cases (9%)

  8. CMS proposes prioritizing patient preferences, linking patients to follow-up care in discharge planning process.

    Science.gov (United States)

    2016-03-01

    Hospital providers voice concerns about a proposed rule by the Centers for Medicare and Medicaid Services (CMS) that would require providers to devote more resources to discharge planning. The rule would apply to inpatients as well as emergency patients requiring comprehensive discharge plans as opposed to discharge instructions. CMS states that the rule would ensure the prioritization of patient preferences and goals in the discharge planning process, and also would prevent avoidable complications and readmissions. However, hospital and emergency medicine leaders worry that community resources are not yet in place to facilitate the links and follow-up required in the proposed rule, and that the costs associated with implementation would be prohibitive. The proposed rule would apply to acute care hospitals, EDs, long-term care facilities, inpatient rehabilitation centers, and home health agencies. Regardless of the setting, though, CMS is driving home the message that patient preferences should be given more weight during the discharge planning process. Under the rule, hospitals or EDs would need to develop a patient-centered discharge plan within 24 hours of admission or registration, and complete the plan prior to discharge or transfer to another facility. Under the rule, emergency physicians would determine which patients require a comprehensive discharge plan. Both the American Hospital Association and the American College of Emergency Physicians worry that hospitals will have to take on more staff, invest in training, and make changes to their electronic medical record systems to implement the provisions in the proposed rule.

  9. Observations and Inferred Physical Characteristics of Compact Intracloud Discharges

    International Nuclear Information System (INIS)

    Argo, P.E.; Eack, K.B.; Holden, D.N.; Massey, R.S.; Shao, X.; Smith, D.A.; Wiens, K.C.

    1999-01-01

    Compact intracloud discharges (CIDS) represent a distinct class of electrical discharges that occur within intense regions of thunderstorms. They are singular discharges that produce brief (typically 3 ampersand micro;s in duration) broadband RF emissions that are 20 to 30 dB more powerful than radiation from all other recorded lightning processes in the HF and VHF radio spectrum. Far field electric field change recordings of CIDS consist of a single, large-amplitude bipolar pulse that begins to rise during the RF-producing phase of the CID and typically lasts for 20 ampersand micro;s. During the summer of 1998 we operated a 4-station array of electric field change meters in New Mexico to support FORTE satellite observations of transient RF and optical sources and to learn more about the phenomenology and physical characteristics of CIDS. Over 800 CIDS were detected and located during the campaign. The events were identified on the basis of their unique field change waveforms. CID source heights determined using the relative delays of ionospherically reflected source emissions were typically between 4 and 11 km above ground level. Events of both positive and negative polarity were observed with events' of initially- negative polarity (indicative of discharges occurring between underlying positive and overlying negative charge) occurring at slightly higher altitudes. Within CID field change waveforms the CID pulse was often followed within a few ms by one or more smaller-amplitude pulses. We associate these subsequent pulses with the initial activity of a ''normal'' intracloud flash, the inference being that some fraction of the time, a CID initiates an intracloud lightning flash

  10. Numerical Modelling of Electrical Discharges

    International Nuclear Information System (INIS)

    Durán-Olivencia, F J; Pontiga, F; Castellanos, A

    2014-01-01

    The problem of the propagation of an electrical discharge between a spherical electrode and a plane has been solved by means of finite element methods (FEM) using a fluid approximation and assuming weak ionization and local equilibrium with the electric field. The numerical simulation of this type of problems presents the usual difficulties of convection-diffusion-reaction problems, in addition to those associated with the nonlinearities of the charged species velocities, the formation of steep gradients of the electric field and particle densities, and the coexistence of very different temporal scales. The effect of using different temporal discretizations for the numerical integration of the corresponding system of partial differential equations will be here investigated. In particular, the so-called θ-methods will be used, which allows to implement implicit, semi-explicit and fully explicit schemes in a simple way

  11. DISCHARGE VALVE FOR GRANULAR MATERIAL

    Science.gov (United States)

    Stoughton, L.D.; Robinson, S.T.

    1962-05-15

    A gravity-red dispenser or valve is designed for discharging the fueled spherical elements used in a pebble bed reactor. The dispenser consists of an axially movable tube terminating under a hood having side walls with openings. When the tube is moved so that its top edge is above the tops of the side openings the elements will not flow. As the tube is moved downwardly, the elements flow into the hood through the side openings and over the top edge into the tube at an increasing rate as the tube is lowered further. The tube is spaced at all times from the hood and side walls a distance greater than the diameter of the largest element to prevent damaging of the elements when the dispenser is closed to flow. (AEC)

  12. Automatic Regulation of Wastewater Discharge

    Directory of Open Access Journals (Sweden)

    Bolea Yolanda

    2017-01-01

    Full Text Available Wastewater plants, mainly with secondary treatments, discharge polluted water to environment that cannot be used in any human activity. When those dumps are in the sea it is expected that most of the biological pollutants die or almost disappear before water reaches human range. This natural withdrawal of bacteria, viruses and other pathogens is due to some conditions such as the salt water of the sea and the sun effect, and the dumps areas are calculated taking into account these conditions. However, under certain meteorological phenomena water arrives to the coast without the full disappearance of pollutant elements. In Mediterranean Sea there are some periods of adverse climatic conditions that pollute the coast near the wastewater dumping. In this paper, authors present an automatic control that prevents such pollution episodes using two mathematical models, one for the pollutant transportation and the other for the pollutant removal in wastewater spills.

  13. Dissemination of satellite-based river discharge and flood data

    Science.gov (United States)

    Kettner, A. J.; Brakenridge, G. R.; van Praag, E.; de Groeve, T.; Slayback, D. A.; Cohen, S.

    2014-12-01

    In collaboration with NASA Goddard Spaceflight Center and the European Commission Joint Research Centre, the Dartmouth Flood Observatory (DFO) daily measures and distributes: 1) river discharges, and 2) near real-time flood extents with a global coverage. Satellite-based passive microwave sensors and hydrological modeling are utilized to establish 'remote-sensing based discharge stations', and observed time series cover 1998 to the present. The advantages over in-situ gauged discharges are: a) easy access to remote or due to political reasons isolated locations, b) relatively low maintenance costs to maintain a continuous observational record, and c) the capability to obtain measurements during floods, hazardous conditions that often impair or destroy in-situ stations. Two MODIS instruments aboard the NASA Terra and Aqua satellites provide global flood extent coverage at a spatial resolution of 250m. Cloud cover hampers flood extent detection; therefore we ingest 6 images (the Terra and Aqua images of each day, for three days), in combination with a cloud shadow filter, to provide daily global flood extent updates. The Flood Observatory has always made it a high priority to visualize and share its data and products through its website. Recent collaborative efforts with e.g. GeoSUR have enhanced accessibility of DFO data. A web map service has been implemented to automatically disseminate geo-referenced flood extent products into client-side GIS software. For example, for Latin America and the Caribbean region, the GeoSUR portal now displays current flood extent maps, which can be integrated and visualized with other relevant geographical data. Furthermore, the flood state of satellite-observed river discharge sites are displayed through the portal as well. Additional efforts include implementing Open Geospatial Consortium (OGC) standards to incorporate Water Markup Language (WaterML) data exchange mechanisms to further facilitate the distribution of the satellite

  14. Presidential Electronic Records Library

    Data.gov (United States)

    National Archives and Records Administration — PERL (Presidential Electronic Records Library) used to ingest and provide internal access to the Presidential electronic Records of the Reagan, Bush, and Clinton...

  15. CMS Records Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Records Schedule provides disposition authorizations approved by the National Archives and Records Administration (NARA) for CMS program-related records...

  16. Discharge estimation combining flow routing and occasional measurements of velocity

    Directory of Open Access Journals (Sweden)

    G. Corato

    2011-09-01

    Full Text Available A new procedure is proposed for estimating river discharge hydrographs during flood events, using only water level data at a single gauged site, as well as 1-D shallow water modelling and occasional maximum surface flow velocity measurements. One-dimensional diffusive hydraulic model is used for routing the recorded stage hydrograph in the channel reach considering zero-diffusion downstream boundary condition. Based on synthetic tests concerning a broad prismatic channel, the "suitable" reach length is chosen in order to minimize the effect of the approximated downstream boundary condition on the estimation of the upstream discharge hydrograph. The Manning's roughness coefficient is calibrated by using occasional instantaneous surface velocity measurements during the rising limb of flood that are used to estimate instantaneous discharges by adopting, in the flow area, a two-dimensional velocity distribution model. Several historical events recorded in three gauged sites along the upper Tiber River, wherein reliable rating curves are available, have been used for the validation. The outcomes of the analysis can be summarized as follows: (1 the criterion adopted for selecting the "suitable" channel length based on synthetic test studies has proved to be reliable for field applications to three gauged sites. Indeed, for each event a downstream reach length not more than 500 m is found to be sufficient, for a good performances of the hydraulic model, thereby enabling the drastic reduction of river cross-sections data; (2 the procedure for Manning's roughness coefficient calibration allowed for high performance in discharge estimation just considering the observed water levels and occasional measurements of maximum surface flow velocity during the rising limb of flood. Indeed, errors in the peak discharge magnitude, for the optimal calibration, were found not exceeding 5% for all events observed in the three investigated gauged sections, while the

  17. Thermal discharge residence by Lake Michigan Salmonids

    International Nuclear Information System (INIS)

    Romberg, G.P.; Prepejchal, W.

    1975-01-01

    Lake Michigan salmon and trout were tagged with a thermoluminescent dosimeter (TLD) temperature tag to estimate their thermal exposure and residence time at a warm water discharge. Fish were collected, tagged, and released at the Point Beach Nuclear Plant, Two Rivers, Wisconsin, in the fall of 1973 and 1974. Tags were recovered during the same season, primarily from fish recaptured at Point Beach. Average uniform temperature exposure and maximum possible discharge residence time were determined. Appropriate hourly intake and discharge temperatures were averaged to calculate mean temperature exposure for the case of maximum discharge residence. Lowest discharge temperature not included within the period of maximum residence was identified to serve as a possible indicator of avoidance temperature. Mean values for the above parameters were calculated for fish species for each tagging year and are reported with the accompanying range of intake and discharge temperatures

  18. Development of Partial Discharging Simulation Test Equipment

    Science.gov (United States)

    Kai, Xue; Genghua, Liu; Yan, Jia; Ziqi, Chai; Jian, Lu

    2017-12-01

    In the case of partial discharge training for recruits who lack of on-site work experience, the risk of physical shock and damage of the test equipment may be due to the limited skill level and improper operation by new recruits. Partial discharge simulation tester is the use of simulation technology to achieve partial discharge test process simulation, relatively true reproduction of the local discharge process and results, so that the operator in the classroom will be able to get familiar with and understand the use of the test process and equipment.The teacher sets up the instrument to display different partial discharge waveforms so that the trainees can analyze the test results of different partial discharge types.

  19. Role of secondary emission on discharge dynamics in an atmospheric pressure dielectric barrier discharge

    Energy Technology Data Exchange (ETDEWEB)

    Tay, W. H.; Kausik, S. S.; Yap, S. L.; Wong, C. S., E-mail: cswong@um.edu.my [Plasma Technology Research Centre, Department of Physics, Faculty of Science, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2014-04-15

    The discharge dynamics in an atmospheric pressure dielectric barrier discharge (DBD) is studied in a DBD reactor consisting of a pair of stainless steel parallel plate electrodes. The DBD discharge has been generated by a 50 Hz ac high voltage power source. The high-speed intensified charge coupled device camera is used to capture the images of filaments occurring in the discharge gap. It is observed that frequent synchronous breakdown of micro discharges occurs across the discharge gap in the case of negative current pulse. The experimental results reveal that secondary emissions from the dielectric surface play a key role in the synchronous breakdown of plasma filaments.

  20. Model of discharge lamps with magnetic ballast

    OpenAIRE

    Molina, Julio; Sainz Sapera, Luis; Mesas García, Juan José; Bergas Jané, Joan Gabriel

    2013-01-01

    Magnetic ballast discharge lamp modeling has been extensively studied because these lamps can be an important source of harmonics. Discharge lamp models usually represent the arc voltage by a square waveform. However, this waveform can be far from actual arc voltages, which affects the accuracy of the lamp models. This paper investigates the actual arc voltage behavior of discharge lamps from laboratory measurements and proposes a novel characterization of these voltages to reformulate the co...

  1. Discharge characteristics of copper vapor laser

    International Nuclear Information System (INIS)

    Nemoto, Koshichi; Fujii, Takashi

    1988-01-01

    This report describes about the copper vapor laser and experimental results of it's discharge characteristics. We measured time varing of plasma regist, and analyzed electron density. (1) The plasma regist is larger than 100Ω at the beginning of discharge, and is rapidly reduced to about 10Ω. (2) The electron density is estimated about 1∼2 x 10 12 /cc at the begining of discharge. (author)

  2. Discharge models through the pressurizer valves

    International Nuclear Information System (INIS)

    Madeira, A.A.

    1985-01-01

    A reliable estimate of discharge through the pressurizer relief and safety valves is of concern to adequately predict the behaviour of RCS pressure during transients. It's investigated the discharge models used by the ALMOD code, and to implement alternative models from the available literature, which are recommended for different conditions of flow that shall exist during transients requiring discharge through the relief and safety valves. (Author) [pt

  3. Fundamental Study on Electrical Discharge Machining

    OpenAIRE

    Uno, Yoshiyuki; Nakajima, Toshikatsu; Endo, Osamu

    1989-01-01

    The generation mechanism of crater in electrical discharge machining is analyzed with a single pulse discharge device for alloy tool steel, black alumina ceramics, cermet and cemented carbide, investigating the gap voltage, the discharge current, the shape of crater, the wear of electrode and so on. The experimental analysis makes it clear that the shape of crater has a characteristic feature for the kind of workpiece. The shape of electrode, which changes with the wear by an electric spark, ...

  4. Secondary mechanisms in a gas discharge

    International Nuclear Information System (INIS)

    Fletcher, J.; Blevin, H.A.

    1978-05-01

    The technique for studying swarms of electrons in a gas discharge by observing the photon flux from the discharge has been adapted to investigate the role of the secondary mechanisms. First results, reported here, show that, contrary to previous indications, ion bombardment of the cathode plays only a negligible, if any, part in the low pressure discharge in hydrogen at E/N approx. less than 200Td

  5. Recharge and discharge calculations to characterize the groundwater hydrologic balance

    International Nuclear Information System (INIS)

    Liddle, R.G.

    1998-01-01

    Several methods are presented to quantify the ground water component of the hydrologic balance; including (1) hydrograph separation techniques, (2) water budget calculations, (3) spoil discharge techniques, and (4) underground mine inflow studies. Stream hydrograph analysis was used to calculate natural groundwater recharge and discharge rates. Yearly continuous discharge hydrographs were obtained for 16 watersheds in the Cumberland Plateau area of Tennessee. Baseflow was separated from storm runoff using computerized hydrograph analysis techniques developed by the USGS. The programs RECESS, RORA, and PART were used to develop master recession curves, calculate ground water recharge, and ground water discharge respectively. Station records ranged from 1 year of data to 60 years of data with areas of 0.67 to 402 square miles. Calculated recharge ranged from 7 to 28 inches of precipitation while ground water discharge ranged from 6 to 25 inches. Baseflow ranged from 36 to 69% of total flow. For sites with more than 4 years of data the median recharge was 20 inches/year and the 95% confidence interval for the median was 16.4 to 23.8 inches of recharge. Water budget calculations were also developed independently by a mining company in southern Tennessee. Results showed about 19 inches of recharge is available on a yearly basis. A third method used spoil water discharge measurements to calculate average recharge rate to the mine. Results showed 21.5 inches of recharge for this relatively flat area strip mine. In a further analysis it was shown that premining soil recharge rates of 19 inches consisted of about 17 inches of interflow and 2 inches of deep aquifer recharge while postmining recharge to the spoils had almost no interflow component. OSM also evaluated underground mine inflow data from northeast Tennessee and southeast Kentucky. This empirical data showed from 0.38 to 1.26 gallons per minute discharge per unit acreage of underground workings. This is the

  6. Understanding discharge communication behaviours in a pediatric emergency care context: a mixed methods observation study protocol.

    Science.gov (United States)

    Curran, Janet A; Bishop, Andrea; Plint, Amy; MacPhee, Shannon; Zemek, Roger; Chorney, Jill; Jabbour, Mona; Porter, Stephen; Sawyer, Scott

    2017-04-17

    One of the most important transitions in the continuum of care for children is discharge to home. Optimal discharge communication between healthcare providers and caregivers (e.g., parents or other guardians) who present to the emergency department (ED) with their children is not well understood. The lack of policies and considerable variation in practice regarding discharge communication in pediatric EDs pose a quality and safety risk for children and their parents. The aim of this mixed methods study is to better understand the process and structure of discharge communication in a pediatric ED context to contribute to the design and development of discharge communication interventions. We will use surveys, administrative data and real-time video observation to characterize discharge communication for six common illness presentations in a pediatric ED: (1) asthma, (2) bronchiolitis, (3) abdominal pain, (4) fever, (5) diarrhea and vomiting, and (6) minor head injury. Participants will be recruited from one of two urban pediatric EDs in Canada. Video recordings will be analyzed using Observer XT. We will use logistic regression to identify potential demographic and visit characteristic cofounders and multivariate logistic regression to examine association between verbal and non-verbal behaviours and parent recall and comprehension. Video recording of discharge communication will provide an opportunity to capture important data such as temporality, sequence and non-verbal behaviours that might influence the communication process. Given the importance of better characterizing discharge communication to identify potential barriers and enablers, we anticipate that the findings from this study will contribute to the development of more effective discharge communication policies and interventions.

  7. Effects of electric discharges on polymers

    International Nuclear Information System (INIS)

    Bagirov, M.A.

    2002-01-01

    Full text: One of the reasons for the worsening of electrical properties of polymeric isolation in use in the effect of the electric discharges which developing in the gas inclusions and in the interlayer inside the isolation itself. The electrical discharges in the gas gap lead to the electrical growing old and the worsening of its electro physical qualities. We have learned the changes of electrical properties (dielectrical permeability and dielectrical loss, and electrical conductivity, electrical strength) of polymer films under the influence of electrical discharges. This paper shows the ways of increase of stability of polymers to the electrical discharges

  8. Medical Injury Identification Using Hospital Discharge Data

    National Research Council Canada - National Science Library

    Layde, Peter M; Meurer, Linda N; Guse, Clare; Meurer, John R; Yang, Hongyan; Laud, Prakash; Kuhn, Evelyn M; Brasel, Karen J; Hargarten, Stephen W

    2005-01-01

    .... The development, validation, and testing of screening criteria for medical injury was based on International Classification of Disease code discharge diagnoses using 2001 patient data from Wisconsin hospitals...

  9. Recent trends on electrical discharge technologies

    International Nuclear Information System (INIS)

    Nakano, Toshiki

    2007-01-01

    Recent trends on the research activities of electrical-discharge-related technologies are summarized as well as the policies of the technical committee on electrical discharges (TC-ED) of IEEJ. First, the present situation of electrical discharge research is mentioned by referring to the major subjects which TC-ED is responsible to cover. As an example of the increasingly widespread use of electrical discharge technologies, vacuum electrical insulation in a neutral beam injection system of the International Thermonuclear Experimental Reactor (ITER) device is presented. (author)

  10. Investigations into electrical discharges in gases

    CERN Document Server

    Klyarfel'D, B N

    2013-01-01

    Investigations into Electrical Discharges in Gases is a compilation of scientific articles that covers the advances in the investigation of the fundamental processes occurring in electrical discharges in gases and vapors. The book details the different aspects of the whole life cycle of an arc, which include the initiation of a discharge, its transition into an arc, the lateral spread of the arc column, and the recovery of electric strength after extinction of an arc. The text also discusses the methods for the dynamic measurement of vapor density in the vicinity of electrical discharges, alon

  11. Readiness for hospital discharge: A concept analysis.

    Science.gov (United States)

    Galvin, Eileen Catherine; Wills, Teresa; Coffey, Alice

    2017-11-01

    To report on an analysis on the concept of 'readiness for hospital discharge'. No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research. Literature review and concept analysis. A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied. Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge. This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital. © 2017 John Wiley & Sons Ltd.

  12. Excimer lamp pumped by a triggered discharge

    Energy Technology Data Exchange (ETDEWEB)

    Baldacchini, G.; Bollanti, S.; Di Lazzaro, P.; Flora, F.; Giordano, G.; Letardi, T.; Renieri, A.; Schina, G. [ENEA, Centro Ricerche Frascati, Rome (Italy). Dip. Innovazione; Clementi, G.; Muzzi, F.; Zheng, C.E. [EL.EN. (Electronic Engineering), Florence (Italy)

    1996-11-01

    Radiation characteristics and discharge performances of an excimer lamp are described. The discharge of the HCl/Xe gas mixture at an atmospheric pressure, occurring near the quartz tube wall, is initiated by a trigger wire. A maximum total UV energy of about 0.4 J in a (0.8-0.9) {mu}s pulse, radiated from a 10 cm discharge length, is obtained with a total discharge input energy of 8 J. Excimer lamps are the preferred choice for medical and material processing irradiations, when the monochromaticity or coherence of UV light is not required, due to their low cost, reliability and easy maintenance.

  13. Determination of Minimum Data Set (MSD) in Echocardiography Reporting System to Exchange with Iran's Electronic Health Record (EHR) System.

    Science.gov (United States)

    Mahmoudvand, Zahra; Kamkar, Mehran; Shahmoradi, Leila; Nejad, Ahmadreza Farzaneh

    2016-04-01

    Determination of minimum data set (MDS) in echocardiography reports is necessary for documentation and putting information in a standard way, and leads to the enhancement of electrocardiographic studies through having access to precise and perfect reports and also to the development of a standard database for electrocardiographic reports. to determine the minimum data set of echocardiography reporting system to exchange with Iran's electronic health record (EHR) system. First, a list of minimum data set was prepared after reviewing texts and studying cardiac patients' records. Then, to determine the content validity of the prepared MDS, the expert views of 10 cardiologists and 10 health information management (HIM) specialists were obtained; to estimate the reliability of the set, test-retest method was employed. Finally, the data were analyzed using SPSS software. The highest degree of consensus was found for the following MDSs: patient's name and family name (5), accepting doctor's name and family name, familial death records due to cardiac disorders, the image identification code, mitral valve, aortic valve, tricuspid valve, pulmonary valve, left ventricle, hole, atrium valve, Doppler examination of ventricular and atrial movement models and diagnoses with an average of. To prepare a model of echocardiography reporting system to exchange with EHR system, creation a standard data set is the vital point. Therefore, based on the research findings, the minimum reporting system data to exchange with Iran's electronic health record system include information on entity, management, medical record, carried-out acts, and the main content of the echocardiography report, which the planners of reporting system should consider.

  14. Ultraviolet and infrared emission from lightning discharges observed at Aragats

    International Nuclear Information System (INIS)

    Chilingarian, A.; Karapetyan, T.; Pokhsraryan, D.; Bogomolov, V.; Garipov, G.; Panasyuk, M.; Svertilov, S.; Saleev, K.

    2016-01-01

    The ultraviolet and infrared optical sensors previously used at RELEC space missions were installed at the high altitude research station Aragats at 3200 m above the sea level. The spectral composition and temporal structure of the recorded optical signals and measurements of the electrostatic field and atmospheric discharges obtained by “fast” and “slow” field sensors have been compared. Measurements of lightning and related to them phenomena observed at the mountain altitude and on board of orbiting satellites are compared. (author)

  15. What Controls Submarine Groundwater Discharge?

    Science.gov (United States)

    Martin, J. B.; Cable, J. E.; Cherrier, J.; Roy, M.; Smith, C. G.; Dorsett, A.

    2008-05-01

    Numerous processes have been implicated in controlling submarine groundwater discharge (SGD) to coastal zones since Ghyben, Herzberg and Dupuit developed models of fresh water discharge from coastal aquifers at the turn of the 19th century. Multiple empirical and modeling techniques have also been applied to these environments to measure the flow. By the mid-1950's, Cooper had demonstrated that dispersion across the fresh water-salt water boundary required salt water entrained into fresh water flow be balanced by recharge of salt water across the sediment-water interface seaward of the outflow face. Percolation of water into the beach face from wind and tidal wave run up and changes in pressure at the sediment-water interface with fluctuating tides have now been recognized, and observed, as processes driving seawater into the sediments. Within the past few years, variations in water table levels and the 1:40 amplification from density difference in fresh water and seawater have been implicated to pump salt water seasonally across the sediment- water interface. Salt water driven by waves, tides and seasonal water table fluctuations is now recognized as a component of SGD when it flows back to overlying surface waters. None of these processes are sufficiently large to provide measured volumes of SGD in Indian River Lagoon, Florida, however, because minimal tides and waves exist, flat topography and transmissive aquifers minimize fluctuations of the water table, and little water is entrained across the salt water-fresh water boundary. Nonetheless, the saline fraction of SGD represents more than 99% of the volume of total SGD in the Indian River Lagoon. This volume of saline SGD can be driven by the abundance of burrowing organisms in the lagoon, which pump sufficient amounts of water through the sediment- water interface. These bioirrigating organisms are ubiquitous at all water depths in sandy sediment and thus may provide one of the major sources of SGD world wide

  16. 77 FR 47380 - Final National Pollutant Discharge Elimination System (NPDES) General Permit for Discharges From...

    Science.gov (United States)

    2012-08-08

    ... test fluids, sanitary waste, domestic waste and miscellaneous discharges is authorized. More stringent... permit. Major changes also include definition of ``operator'', acute toxicity test for produced water, spill prevention best management practices, and electronic reporting requirements. To obtain discharge...

  17. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  18. A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients.

    Science.gov (United States)

    Armstrong, James; Forrest, Helen; Crawford, Mark W

    2015-10-01

    Discharge criteria based on physiological scoring systems can be used in the postanesthesia care unit (PACU) to fast-track patients after ambulatory surgery; however, studies comparing physiological scoring systems with traditional time-based discharge criteria are lacking. The purpose of this study was to compare PACU discharge readiness times using physiological vs time-based discharge criteria in pediatric ambulatory surgical patients. We recorded physiological observations from consecutive American Society of Anesthesiologists physical status I-III patients aged 1-18 yr who were admitted to the PACU after undergoing ambulatory surgery in a tertiary academic pediatric hospital. The physiological score was a combination of the Aldrete and Chung systems. Scores were recorded every 15 min starting upon arrival in the PACU. Patients were considered fit for discharge once they attained a score ≥12 (maximum score, 14), provided no score was zero, with the time to achieve a score ≥12 defining the criteria-based discharge (CBD) time. Patients were discharged from the PACU when both the CBD and the existing time-based discharge (TBD) criteria were met. The CBD and TBD data were compared using Kaplan-Meier and log-rank analysis. Observations from 506 children are presented. Median (interquartile range [IQR]) age was 5.5 [2.8-9.9] yr. Median [IQR] CBD and TBD PACU discharge readiness times were 30 [15-45] min and 60 [45-60] min, respectively. Analysis of Kaplan-Meier curves indicated a significant difference in discharge times using the different criteria (hazard ratio, 5.43; 95% confidence interval, 4.51 to 6.53; P < 0.001). All patients were discharged home without incident. This prospective study suggests that discharge decisions based on physiological criteria have the potential for significantly speeding the transit of children through the PACU, thereby enhancing PACU efficiency and resource utilization.

  19. Discharge lamp with reflective jacket

    Science.gov (United States)

    MacLennan, Donald A.; Turner, Brian P.; Kipling, Kent

    2001-01-01

    A discharge lamp includes an envelope, a fill which emits light when excited disposed in the envelope, a source of excitation power coupled to the fill to excite the fill and cause the fill to emit light, and a reflector disposed around the envelope and defining an opening, the reflector being configured to reflect some of the light emitted by the fill back into the fill while allowing some light to exit through the opening. The reflector may be made from a material having a similar thermal index of expansion as compared to the envelope and which is closely spaced to the envelope. The envelope material may be quartz and the reflector material may be either silica or alumina. The reflector may be formed as a jacket having a rigid structure which does not adhere to the envelope. The lamp may further include an optical clement spaced from the envelope and configured to reflect an unwanted component of light which exited the envelope back into the envelope through the opening in the reflector. Light which can be beneficially recaptured includes selected wavelength regions, a selected polarization, and selected angular components.

  20. Fluid jet electric discharge source

    Science.gov (United States)

    Bender, Howard A [Ripon, CA

    2006-04-25

    A fluid jet or filament source and a pair of coaxial high voltage electrodes, in combination, comprise an electrical discharge system to produce radiation and, in particular, EUV radiation. The fluid jet source is composed of at least two serially connected reservoirs, a first reservoir into which a fluid, that can be either a liquid or a gas, can be fed at some pressure higher than atmospheric and a second reservoir maintained at a lower pressure than the first. The fluid is allowed to expand through an aperture into a high vacuum region between a pair of coaxial electrodes. This second expansion produces a narrow well-directed fluid jet whose size is dependent on the size and configuration of the apertures and the pressure used in the reservoir. At some time during the flow of the fluid filament, a high voltage pulse is applied to the electrodes to excite the fluid to form a plasma which provides the desired radiation; the wavelength of the radiation being determined by the composition of the fluid.

  1. The radiofrequency magnetic dipole discharge

    Energy Technology Data Exchange (ETDEWEB)

    Martines, E., E-mail: emilio.martines@igi.cnr.it; Zuin, M.; Cavazzana, R.; Fassina, A.; Spolaore, M. [Consorzio RFX (CNR, ENEA, INFN, Università di Padova, Acciaierie Venete SpA), Corso Stati Uniti 4, 35127 Padova (Italy); Marcante, M. [Dipartimento di Fisica, Università di Trento, via Sommarive 14, 38123 Povo, TN (Italy); TIFPA, Trento Institute for Fundamental Physics and Applications INFN, 38123 Trento (Italy)

    2016-05-15

    This paper describes a novel and simple concept of plasma source, which is able to produce a radiofrequency magnetized discharge with minimal power requirements. The source is based on the magnetron concept and uses a permanent magnet as an active electrode. The dipolar field produced by the magnet confines the electrons, which cause further ionization, thus producing a toroidally shaped plasma in the equatorial region around the electrode. A plasma can be ignited with such scheme with power levels as low as 5 W. Paschen curves have been built for four different working gases, showing that in Helium or Neon, plasma breakdown is easily obtained also at atmospheric pressure. The plasma properties have been measured using a balanced Langmuir probe, showing that the electron temperature is around 3–4 eV and higher in the cathode proximity. Plasma densities of the order of 10{sup 16 }m{sup −3} have been obtained, with a good positive scaling with applied power. Overall, the electron pressure appears to be strongly correlated with the magnetic field magnitude in the measurement point.

  2. The radiofrequency magnetic dipole discharge

    Science.gov (United States)

    Martines, E.; Zuin, M.; Marcante, M.; Cavazzana, R.; Fassina, A.; Spolaore, M.

    2016-05-01

    This paper describes a novel and simple concept of plasma source, which is able to produce a radiofrequency magnetized discharge with minimal power requirements. The source is based on the magnetron concept and uses a permanent magnet as an active electrode. The dipolar field produced by the magnet confines the electrons, which cause further ionization, thus producing a toroidally shaped plasma in the equatorial region around the electrode. A plasma can be ignited with such scheme with power levels as low as 5 W. Paschen curves have been built for four different working gases, showing that in Helium or Neon, plasma breakdown is easily obtained also at atmospheric pressure. The plasma properties have been measured using a balanced Langmuir probe, showing that the electron temperature is around 3-4 eV and higher in the cathode proximity. Plasma densities of the order of 1016 m-3 have been obtained, with a good positive scaling with applied power. Overall, the electron pressure appears to be strongly correlated with the magnetic field magnitude in the measurement point.

  3. Current discharge management of acute coronary syndromes: baseline results from a national quality improvement initiative.

    Science.gov (United States)

    Wai, A; Pulver, L K; Oliver, K; Thompson, A

    2012-05-01

    Evidence-practice gaps exist in the continuum of care for patients with acute coronary syndromes (ACS), particularly at hospital discharge. We aimed to describe the methodology and baseline results of the Discharge Management of Acute Coronary Syndromes (DMACS) project, focusing on the prescription of guideline-recommended medications, referral to cardiac rehabilitation and communication between the hospital, patient and their primary healthcare professionals. DMACS employed Drug Use Evaluation methodology involving data collection, evaluation and feedback, and targeted educational interventions. Adult patients with ACS discharged during a 4-month period were eligible to participate. Data were collected (maximum 50 patients) at each site through an inpatient medical record review, a general practitioner (GP) postal/fax survey conducted 14 days post discharge and a patient telephone survey 3 months post discharge. Forty-nine hospitals participated in the audit recruiting 1545 patients. At discharge, 57% of patients were prescribed a combination of antiplatelet agent(s), beta-blocker, statin and angiotensin-converting enzyme inhibitor and/or angiotensin II-antagonist. At 3 months post discharge, 48% of patients reported using the same combination. Some 67% of patients recalled being referred to cardiac rehabilitation; of these, 33% had completed the programme. In total, 83% of patients had a documented ACS management plan at discharge. Of these, 90% included a medication list, 56% a chest pain action plan and 54% risk factor modification advice. Overall, 65% of GPs rated the quality of information received in the discharge summary as 'very good' to 'excellent'. The findings of our baseline audit showed that despite the robust evidence base and availability of national guidelines, the management of patients with ACS can be improved. These findings will inform a multifaceted intervention strategy to improve adherence to guidelines for the discharge management of

  4. ARC discharge sliding over a conducting surface

    NARCIS (Netherlands)

    van Goor, F.A.; Mitko, S.; Ochkin, V.N.; Paramonov, A.P.; Witteman, W.J.

    1997-01-01

    Results of experimental and theoretical studies of the arc discharge which slides over the surface of a conductor are reported. Experiments were performed in air and argon ambients at various pressures. It is found that the velocity of the discharge plasma front depends linearly on the strength of

  5. Study of gliding arc discharge plasma

    International Nuclear Information System (INIS)

    Yang Chi; Lin Lie; Wu Bin

    2006-01-01

    The electric parameters change during discharge is studied and the relationship between non-equilibrium degree and parameters is discussed for gliding arc discharges. Using two-channel model, the rules of arc moving due to effect of the airflow is simulated. The numerical simulation results can help analyzing the generation mechanism of gliding arc non-equilibrium plasma. (authors)

  6. Partial discharges and bulk dielectric field enhancement

    DEFF Research Database (Denmark)

    McAllister, Iain Wilson; Johansson, Torben

    2000-01-01

    A consequence of partial discharge activity within a gaseous void is the production of a field enhancement in the solid dielectric in the proximity of the void. This situation arises due to the charge created by the partial discharges accumulating at the void wall. The influence of the spatial...

  7. Capacitor Discharge - A Capacitor Tutorial [video

    OpenAIRE

    Naval Postgraduate School Physics

    2014-01-01

    NPS Physics Physics Demonstrations Here's a capacitor discharge demonstrated by physicist Dr. Dernardo. Dr. D gives a nice capacitor lesson along with some fireworks. Charging and Discharging a Capacitor is dangerous. Do not try this at home. Dr. Bruce Denardo uses eleven 9V batteries, connected in series for a total of 99 creating a pretty large spark.

  8. Parental experiences of early postnatal discharge

    DEFF Research Database (Denmark)

    Nilsson, Ingrid; Danbjørg, Dorthe B.; Aagaard, Hanne

    2015-01-01

    that included both parents, having influence on time of discharge, and getting individualised and available support focused on developing and recognising their own experiences of taking care of the baby. Conclusions and implications for practice the new parents׳ experiences of early discharge and becoming...

  9. THE DISCHARGING EAR: A PRACTICAL APPROACH

    African Journals Online (AJOL)

    Enrique

    The colour of the fluid can suggest the cause of the otorrhoea. A purulent dis- charge indicates the presence of infection, while a bloody discharge may follow trauma or occur with granulation tissue associated with chronic infection. The presence of a mucoid discharge indicates a perforation of the tympanic mem-.

  10. Runaway electron beam in atmospheric pressure discharges

    International Nuclear Information System (INIS)

    Oreshkin, E V; Barengolts, S A; Chaikovsky, S A; Oreshkin, V I

    2015-01-01

    A numerical simulation was performed to study the formation of a runaway electron (RAE) beam from an individual emission zone in atmospheric pressure air discharges with a highly overvolted interelectrode gap. It is shown that the formation of a RAE beam in discharges at high overvoltages is much contributed by avalanche processes. (paper)

  11. The discharge characteristics in nitrogen helicon plasma

    Science.gov (United States)

    Zhao, Gao; Wang, Huihui; Si, Xinlu; Ouyang, Jiting; Chen, Qiang; Tan, Chang

    2017-12-01

    Discharge characteristics of helicon plasma in nitrogen and argon-nitrogen mixtures were investigated experimentally by using a Langmuir probe, a B-dot probe, and an optical emission spectrum. Helicon wave discharge is confirmed by the changes of electron density and electromagnetic signal amplitude with the increasing RF power, which shows three discharge stages in nitrogen, corresponding to E-mode, H-mode, and W-mode discharges in helicon plasma, respectively. Discharge images in the radial cross section at different discharge modes through an intensified charge coupled device (ICCD) show a rapid increase in luminous intensity along with the RF power. When the nitrogen discharge is in the W-mode, the images show that the strongest luminance locates near the plasma boundary and no blue core appears in the axial center of tube, which is always observed in argon W-mode discharge. The "big blue" or blue core is a special character in helicon plasma, but it has not been observed in nitrogen helicon plasma. In nitrogen-argon mixtures, a weak blue core is observed in ICCD images since the nitrogen content is increased. The electric field turns to the periphery in the distribution of the radial field and the electron temperature decreases with the increasing nitrogen content, especially when the blue core disappears. The different behaviors of the electron impact and the energy consumption in nitrogen helicon plasma are suggested to be responsible for the decrease in electron energy and the change in the electric field distribution.

  12. [Severe vaginal discharge following rectal surgery

    NARCIS (Netherlands)

    Burg, L.C.; Bremers, A.J.A.; Heesakkers, J.P.; Kluivers, K.B.

    2018-01-01

    BACKGROUND: Almost 50% of women who have had rectal surgery subsequently develop vaginal discharge. Due to the recurrent and unexpected nature of this heavy discharge, they often experience it as very distressing. Many of these women undergo extensive diagnostic tests that are mainly focused on

  13. Waste water discharges into natural waters

    International Nuclear Information System (INIS)

    Marri, P.; Barsanti, P.; Mione, A.; Posarelli, M.

    1996-12-01

    The aqueous discharges into natural waters is a very technical solution expecially for surface buoyant discharges. It is not only convenient to limit the concentration levels of the discharges, but also to improve the turbolent processes that diluite the discharge. Mostly these processes depend by some geometric parameters of the discharge and by some physical parameters of the effluent and of the receiving water body. An appropriate choice of some parameters, using also suitable mathematical models, allows to design discharges with a very high dilution; so the decreasing of the pollutant levels is improved and the environmental impact can be reduced versus a not diluted effluent. The simulations of a mathematical model, here described, prove that in some circumstances, expecially in case of discharges of fresh water into saline water bodies with a low velocity of the current, the dilution is poor; the effluent can be trapped in a narrow water surface layer where the pollutant concentrations remain high. also far away from the discharge point

  14. EPA Region 1 No Discharge Zones

    Science.gov (United States)

    This dataset details No Discharge Zones (NDZ) for New England. Boaters may not discharge waste into these areas. Boundaries were determined mostly by Federal Register Environmental Documents in coordination with Massachusetts Coastal Zone Management (MA CZM) and EPA Region 1 Office of Ecosystem Protection (OEP) staff.

  15. [Effect of electromagnetic radiation on discharge activity of neurons in the hippocampus CA1 in rats].

    Science.gov (United States)

    Tong, Jun; Chen, Su; Liu, Xiang-Ming; Hao, Dong-Mei

    2013-09-01

    In order to explore effect of electromagnetic radiation on learning and memory ability of hippocampus neuron in rats, the changes in discharge patterns and overall electrical activity of hippocampus neuron after electromagnetic radiation were observed. Rat neurons discharge was recorded with glass electrode extracellular recording technology and a polygraph respectively. Radiation frequency of electromagnetic wave was 900 MHZ and the power was 10 W/m2. In glass electrode extracellular recording, the rats were separately irradiated for 10, 20, 30, 40, 50 and 60 min, every points repeated 10 times and updated interval of 1h, observing the changes in neuron discharge and spontaneous discharge patterns after electromagnetic radiation. In polygraph recording experiments, irradiation group rats for five days a week, 6 hours per day, repeatedly for 10 weeks, memory electrical changes in control group and irradiation group rats when they were feeding were repeatedly monitored by the implanted electrodes, observing the changes in peak electric digits and the largest amplitude in hippocampal CA1 area, and taking some electromagnetic radiation sampling sequence for correlation analysis. (1) Electromagnetic radiation had an inhibitory role on discharge frequency of the hippocampus CA1 region neurons. After electromagnetic radiation, discharge frequency of the hippocampus CA1 region neurons was reduced, but the changes in scale was not obvious. (2) Electromagnetic radiation might change the spontaneous discharge patterns of hippocampus CA1 region neurons, which made the explosive discharge pattern increased obviously. (3) Peak potential total number within 5 min in irradiation group was significantly reduced, the largest amplitude was less than that of control group. (4) Using mathematical method to make the correlation analysis of the electromagnetic radiation sampling sequence, that of irradiation group was less than that of control group, indicating that there was a tending

  16. Distribution of the active liquid waste discharge concentration

    International Nuclear Information System (INIS)

    Chan, A.H.C.

    1985-03-01

    In assessing the proposal for removing the on-line liquid effluent monitor (LEM) from the Darlington NGS-A design, it was required to estimate the probability that the concentration of β-y emitters in the active liquid waste (ALW) tank discharges exceeds a specified level. To achieve this, it was necessary to know the underlying distribution of the ALW discharge concentration. Since the distribution could only be estimated from the historical data, it was also important to provide the confidence interval for the estimated probability. Using the ALW discharge records of Pickering and Bruce NGS-A, it was found that the log-normal distribution provided the best fit for the data. The frequency of the tank concentration exceeding the specified level of 24000μCi/m 3 was estimated to be 1 in 200,000 years at Bruce NGS-A and 1 in 100,000 years at Pickering. The 99% upper confidence limits are 1 in 2777 years and 1 in 77 years, respectively

  17. A DESCRIPTIVE STUDY OF FUNGAL INFECTIONS IN CHRONICALLY DISCHARGING EARS

    Directory of Open Access Journals (Sweden)

    Sujatha

    2015-08-01

    Full Text Available BACKGROUND : Chronic Suppurative Otitis Media (CSOM is a disease of multiple aetiology and well known for its persis tence and recurrence inspite of treatment and are the bearbug of otologist, paediatrician and general practitioner. One of the reason s for the refractoriness to treatment and chronicity is coexist ing fungal infection of the ear. OBJECTIVES: Are to find out the prevalence of fungal infections in chronic discharging ears and to identify and isolate the type of fungus prevalent in these ears . MATERIALS AND METHOD S: Tertiary care hospital level descrip tive study was conducted in 50 cases of CSOM with actively discharging ears for a period of one year starting from February 2013. For all the cases aural swabs were collected from the diseased ear and were used for direct microscopic examination in potassi um hydroxide wet mount. Ear swab was cultured on Sabouraud’s dextrose agar plate for fungal cultures. The patient characteristics were prospectively recorded and results were analysed. CONCLUSION : There is high prevalence of coexisting fungal infection in actively discharging ears of CSOM patients

  18. Discharge optimization and the control of edge stability

    International Nuclear Information System (INIS)

    Nave, M.F.F.; Lomas, P.J.; Huysmans, G.T.A.

    1999-01-01

    Discharge optimization for improving MHD stability of both core and edge was essential for the achievement of record fusion power discharges, in the ELM-free hot ion H mode regime, in the recent JET DT operation. The techniques used to increase edge stability are described. In particular the successful technique of current rampdown used to suppress the outer mode is reported. The increased stability of the outer mode by decreasing the edge current density confirms its identification as an n = 1 external kink. Decreasing the plasma current, however, decreases the ELM-free period, which is consistent with stability calculations that show an earlier onset of the ballooning limit. In order to increase external kink stability without causing a deterioration in the ELM-free period, a compromise was achieved by using plasma current rampdown, while working at the highest plasma current values possible. Results from a plasma current scan show that at the time of occurrence of the first giant ELM, the plasma stored energy, as well as the pressure measured at the top of the edge pedestal increase linearly with plasma current, for a given plasma configuration and power. This is consistent with models of the edge transport barrier, where the transport barrier width is proportional to the ion (or fast ion) poloidal Larmor radius. The MHD observations in DT and deuterium only discharges were found to be similar. Thus the experience gained on the control of MHD modes in deuterium plasmas could be fully exploited in the DT campaign. (author)

  19. Ion clusters, REB, and current sheath characteristics in focused discharges

    International Nuclear Information System (INIS)

    Bortolotti, A.; Brzosko, J.; DeChiara, P.; Kilic, H.; Mezzetti, F.; Nardi, V.; Powell, C.; Zeng, D.

    1990-01-01

    Small fluctuations in the current sheath characteristics (peak current density, FWHM of leading sheath, control parameters of sheath internal structure) are linked to wide fluctuations of ion and ion cluster emission from the pinch. Magnetic probe data are used for correlating variations of current sheath parameters with particle emission intensity, Z/M composition, particle energy spectrum. The emission of ion and ion clusters at 90 degrees from the axis of a plasma focus discharge is monitored simultaneously with the 0 degrees emission. The particle energy spectrum is analyzed with a Thomson (parabola) spectrometer (time resolution ∼ 1 nanosec). The cross-sectional structure of the REB at 180 degrees along the discharge axis is monitored via the deposition of collective-field accelerated ions on a target in the REB direction. Etched tracks of ion and ion clusters are in all cases recorded on CR-39 plates. Sharp peaks of the D + -ion spectrum at 90 degrees are found for E > 200 keV/unit charge in all focused discharges. These peaks are due to ion crossing of the azimuthal magnetic field of the pinch region, in a predominant ion cluster structure

  20. Plasma pressure in the discharge column of the Novillo Tokamak

    International Nuclear Information System (INIS)

    Gaytan G, E.

    1995-01-01

    The design and construction of an acquisition system for the measurement of the plasma pressure in the Novillo Tokamak is described in detail. The system includes a high voltage ramp generator, a hardware and a software interface with a personal computer. It is used to determine experimentally the variations of the pressure in the plasma column in the cleaning and main discharges. The measurement of the pressure is made with a Pirani sensor adapted to the acquisition hardware and synchronized with the discharge in the plasma. The software is made in object oriented programming as a graphic interface designed to be used easily. It controls the acquisition, records the data, displays in graphic form the results and save the measurements. The graphic interface is a building block that can be used in different acquisition tasks. The ramp generator can deliver a signal of 200 V peak to peak with a current of 200 m A and offset control. The acquisition time is 2.5 μ s for every measurement, 8192 measurements can be stored in the acquisition board for every discharge. (Author)

  1. Plasma deposition by discharge in powder

    International Nuclear Information System (INIS)

    El-Gamal, H.A.; El-Tayeb, H.A.; Abd El-Moniem, M.; Masoud, M.M.

    2000-01-01

    Different types of material powders have been fed to the breach of a coaxial discharge. The coaxial discharge is powered from a 46.26 mu F, 24 KV capacitor bank. When the discharge takes place at the breach, the powder is heated and ionized to form a sheath of its material. The plasma sheath is ejected from the discharge zone with high velocity. The plasma sheath material is deposited on a glass substrate. It has been found from scanning electron microscope (SEM) analysis that the deposited material is almost homogenous for ceramic and graphite powders. The grain size is estimated to be the order of few microns. To measure the deposited material thickness the microdensitometer and a suitable arrangement of a laser interferometer and an optical microscope are used. It has also been found that deposited material thickness depends on the discharge number of shots and the capacitor bank energy

  2. Supersonic CO electric-discharge lasers

    Science.gov (United States)

    Hason, R. K.; Mitchner, M.; Stanton, A.

    1975-01-01

    Laser modeling activity is described which involved addition of an option allowing N2 as a second diatomic gas. This option is now operational and a few test cases involving N2/CO mixtures were run. Results from these initial test cases are summarized. In the laboratory, a CW double-discharge test facility was constructed and tested. Features include: water-cooled removable electrodes, O-ring construction to facilitate cleaning and design modifications, increased discharge length, and addition of a post-discharge observation section. Preliminary tests with this facility using N2 yielded higher power loadings than obtained in the first-generation facility. Another test-section modification, recently made and as yet untested, will permit injection of secondary gases into the cathode boundary layer. The objective will be to vary and enhance the UV emission spectrum from the auxiliary discharge, thereby influencing the level of photoionization in the main discharge region.

  3. Paschen like behavior in argon RF discharge

    International Nuclear Information System (INIS)

    Al-Jwaady, Y. I.

    2011-01-01

    A 13.56 MHz radio frequency inductively coupled discharge system is used in this work to study the relation between Argon gas pressure in the discharge chamber and the threshold breakdown RF power needed to create the discharge. Experimental results indicated that although the data involve some features related to the traditional Paschen relation used in Dc discharge, this relation cannot provide a quantitative description of experimental data. For such reason, a modified from Paschen relation is suggested. The modified relation provides good agreement with experimental data. Furthermore, it seems that the Paschen relation will have significant reflections on the behavior of the transit process from capacitive to inductive discharge. This is demonstrated by studying the transit region. (author)

  4. Acoustic effects of single electrostatic discharges

    International Nuclear Information System (INIS)

    Orzech, Łukasz

    2015-01-01

    Electric discharges, depending on their character, can emit different types of energy, resulting in different effects. Single electrostatic discharges besides generation of electromagnetic pulses are also the source of N acoustic waves. Their specified parameters depending on amount of discharging charge enable determination of value of released charge in a function of acoustic descriptor (e.g. acoustic pressure). Presented approach is the basics of acoustic method for measurement of single electrostatic discharges, enabling direct and contactless measurement of value of charge released during ESD. Method for measurement of acoustic effect of impact of a single electrostatic discharge on the environment in a form of pressure shock wave and examples of acoustic descriptors in a form of equation Q=f(p a ) are described. The properties of measuring system as well as the results of regression static analyses used to determine the described relationships are analysed in details. (paper)

  5. Impact of Pharmacist Facilitated Discharge Medication Reconciliation

    Directory of Open Access Journals (Sweden)

    Todd M. Super

    2014-07-01

    Full Text Available Preventable adverse drug events occur frequently at transitions in care and are a problem for many patients following hospital discharge. Many of these problems can be attributed to poor medication reconciliation. The purpose of this study was to assess the impact that direct pharmacist involvement in the discharge medication reconciliation process had on medication discrepancies, patient outcomes, and satisfaction. A cohort study of 70 patients was designed to assess the impact of pharmacist facilitated discharge medication reconciliation at a 204-bed community hospital in Battle Creek, Michigan, USA. Discharge summaries were analyzed to compare patients who received standard discharge without pharmacist involvement to those having pharmacist involvement. The total number of discrepancies in the group without pharmacist involvement was significantly higher than that of the pharmacist facilitated group.

  6. Prediction of rhythmic and periodic EEG patterns and seizures on continuous EEG with early epileptiform discharges.

    Science.gov (United States)

    Koren, J; Herta, J; Draschtak, S; Pötzl, G; Pirker, S; Fürbass, F; Hartmann, M; Kluge, T; Baumgartner, C

    2015-08-01

    Continuous EEG (cEEG) is necessary to document nonconvulsive seizures (NCS), nonconvulsive status epilepticus (NCSE), as well as rhythmic and periodic EEG patterns of 'ictal-interictal uncertainty' (RPPIIU) including periodic discharges, rhythmic delta activity, and spike-and-wave complexes in neurological intensive care patients. However, cEEG is associated with significant recording and analysis efforts. Therefore, predictors from short-term routine EEG with a reasonably high yield are urgently needed in order to select patients for evaluation with cEEG. The aim of this study was to assess the prognostic significance of early epileptiform discharges (i.e., within the first 30 min of EEG recording) on the following: (1) incidence of ictal EEG patterns and RPPIIU on subsequent cEEG, (2) occurrence of acute convulsive seizures during the ICU stay, and (3) functional outcome after 6 months of follow-up. We conducted a separate analysis of the first 30 min and the remaining segments of prospective cEEG recordings according to the ACNS Standardized Critical Care EEG Terminology as well as NCS criteria and review of clinical data of 32 neurological critical care patients. In 17 patients with epileptiform discharges within the first 30 min of EEG (group 1), electrographic seizures were observed in 23.5% (n = 4), rhythmic or periodic EEG patterns of 'ictal-interictal uncertainty' in 64.7% (n = 11), and neither electrographic seizures nor RPPIIU in 11.8% (n = 2). In 15 patients with no epileptiform discharges in the first 30 min of EEG (group 2), no electrographic seizures were recorded on subsequent cEEG, RPPIIU were seen in 26.7% (n = 4), and neither electrographic seizures nor RPPIIU in 73.3% (n = 11). The incidence of EEG patterns on cEEG was significantly different between the two groups (p = 0.008). Patients with early epileptiform discharges developed acute seizures more frequently than patients without early epileptiform discharges (p = 0.009). Finally, functional

  7. FDX: a fast discharge homopolar generator

    International Nuclear Information System (INIS)

    Weldon, W.F.; Rylander, H.G.; Woodson, H.H.

    1977-01-01

    A study was undertaken to determine the fundamental limitations to the discharge times of homopolar generators. As a result of the study, a Fast Discharge Experiment (FDX) was proposed. FDX is a small (365 kJ), counterrotating disk type homopolar generator designed to explore the limits to homopolar generator discharge times. The FDX rotors are forged aluminum alloy with flame sprayed copper slip rings. Solid copper graphite brushes are used with a 95% packing factor on the slip rings. The high magnetic field required for fast discharge (3.6 T average) is provided by discharging the CEM 5.0 MJ homopolar generator into a four-turn, graphite-reinforced, room temperature copper coil. Since the field is pulsed and FDX rotors cannot be self motored, they are brought up to speed with two 37 kW air turbines. The two aluminum rotors are 30 cm in diameter and of a rimmed, modified constant stress configuration. They are designed for a maximum operating speed of 28,000 r/min at which point they each store 182.5 kJ and develop 104 V. The aluminum discharge coax is approximately 38 cm in diameter and is designed to carry the 1.88 MA anticipated from a half speed (14,000 r/min) short circuit discharge which would stop the rotors in 1.0 ms. It is predicted that the machine will ring on its own internal impedance for approximately five cycles in this mode. The discharge coax is shorted by four very fast making switches. Additional impedance can be introduced into the discharge circuit by extending the switch coaxes to allow full speed 1.4 MA discharges in approximately 3.5 ms

  8. Numerical investigation of dielectric barrier discharges

    Science.gov (United States)

    Li, Jing

    1997-12-01

    A dielectric barrier discharge (DBD) is a transient discharge occurring between two electrodes in coaxial or planar arrangements separated by one or two layers of dielectric material. The charge accumulated on the dielectric barrier generates a field in a direction opposite to the applied field. The discharge is quenched before an arc is formed. It is one of the few non-thermal discharges that operates at atmospheric pressure and has the potential for use in pollution control. In this work, a numerical model of the dielectric barrier discharge is developed, along with the numerical approach. Adaptive grids based on the charge distribution is used. A self-consistent method is used to solve for the electric field and charge densities. The Successive Overrelaxation (SOR) method in a non-uniform grid spacing is used to solve the Poisson's equation in the cylindrically-symmetric coordinate. The Flux Corrected Transport (FCT) method is modified to solve the continuity equations in the non-uniform grid spacing. Parametric studies of dielectric barrier discharges are conducted. General characteristics of dielectric barrier discharges in both anode-directed and cathode-directed streamer are studied. Effects of the dielectric capacitance, the applied field, the resistance in external circuit and the type of gases (O2, air, N2) are investigated. We conclude that the SOR method in an adaptive grid spacing for the solution of the Poisson's equation in the cylindrically-symmetric coordinate is convergent and effective. The dielectric capacitance has little effect on the g-factor of radical production, but it determines the strength of the dielectric barrier discharge. The applied field and the type of gases used have a significant role on the current peak, current pulse duration and radical generation efficiency, discharge strength, and microstreamer radius, whereas the external series resistance has very little effect on the streamer properties. The results are helpful in

  9. A holographic method for investigating cylindrical symmetry plasmas resulting from electric discharges

    International Nuclear Information System (INIS)

    Rosu, N.; Ralea, M.; Foca, M.; Iova, I.

    1992-01-01

    A new method based on holographic interferometry in real time with reference fringes for diagnosing gas electric discharges in cylindrical symmetry tubes is presented. A method for obtaining and quantitatively investigating interferograms obtained with a video camera is described. By studying the resulting images frame by frame and introducing the measurements into an adequate computer programme one gets a graphical recording of the radial distribution of the charged particle concentration in the plasma in any region of the tube at a given time, as well as their axial distribution. The real time evolution of certain phenomena occurring in the discharge tube can also be determined by this non-destructive method. The method is used for electric discharges in Ar at average pressures in a discharge tube with hollow cathode effect. (Author)

  10. Radioactive liquid wastes discharged to ground in the 200 areas during 1985

    International Nuclear Information System (INIS)

    Aldrich, R.C.

    1986-03-01

    This document summarizes radioactive liquids discharged to the ground in the 200 areas of the Hanford site and is provided pursuant to Department of Energy (DOE) Order 5484.1A, ''Environmental Protection, Safety, and Health Protection Information Reporting Requirements.'' There are twenty-eight liquid discharge streams in the 200 areas excluding sanitary sewers. Twenty-five streams were normally or potentially contaminated with radioactive material in 1985. Two streams had no potential for radioactive contamination but were included as adjustments in this report to maintain an accurate record of the total volume of the discharges to each disposal site. One stream, the 242-S Evaporator cooling water discharge, was not used during 1985

  11. Luminescent Characteristics of a Pulsed Discharge Plasma in Xe-KBr Mixture

    Science.gov (United States)

    Heneral, A. A.; Zhmenyak, Y. V.

    2018-03-01

    A mixture of xenon with a nontoxic halogen carrier Xe-KBr is used to create a plasma radiation source at the 282-nm transition of the XeBr* molecule excited by a high-voltage pulsed-periodic discharge. The luminescence spectra of the plasma of a longitudinal pulsed-periodic discharge in the Xe-KBr mixture at low pressures are studied experimentally. The most intense UV bands of exciplex XeBr* molecules are recorded in the spectral range of 250-350 nm. The spectral, temporal, and energetic characteristics of the radiation source are presented, as well as the dependence of the XeBr* exciplex molecule formation efficiency on the discharge excitation conditions. The optimal conditions for the excitation of UV radiation in the pulsed-periodic discharge plasma are determined.

  12. Changing climate increases discharge and attenuates its seasonal distribution in the northeastern United States

    Directory of Open Access Journals (Sweden)

    Rouzbeh Berton

    2016-03-01

    Full Text Available Study region: The Hubbard Brook Experimental Forest is well-established as a Long-Term Ecological Research (LTER site for climate change and anthropogenic impacts studies on hydrological processes. It is located at the headwater regions of the Merrimack Watershed, the fourth largest basin in New England, USA. The watershed is mostly forested (67% with some developed regions (16%. Study focus: We assessed the scale-dependency of streamflow response to climate variation, river regulation, and development for dry, average, and wet years using long-term precipitation and discharge records. New hydrological insights for the region: The effects of basin scale were limited to discharges with exceedance probability less than 15% and greater than 60% and were expressed as lagged discharge in large sub-basins and earlier discharge in small catchments. Annual discharge responded to increases in annual precipitation but not to river regulation or land development. In general, the temporal trends showed less discharge in dry and greater discharge in wet hydrologic flow classes. Keywords: Climate change, Land development, Hydrologic indicator, Scale dependency, Merrimack river, Northeastern United States

  13. A Modified Water-Table Fluctuation Method to Characterize Regional Groundwater Discharge

    Directory of Open Access Journals (Sweden)

    Lihong Yang

    2018-04-01

    Full Text Available A modified Water-Table Fluctuation (WTF method is developed to quantitatively characterize the regional groundwater discharge patterns in stressed aquifers caused by intensive agricultural pumping. Two new parameters are defined to express the secondary information in the observed data. One is infiltration efficiency and the other is discharge modulus (recurring head loss due to aquifer discharge. An optimization procedure is involved to estimate these parameters, based on continuous groundwater head measurements and precipitation records. Using the defined parameters and precipitation time series, water level changes are calculated for individual wells with fidelity. The estimated parameters are then used to further address the characterization of infiltration and to better quantify the discharge at the regional scale. The advantage of this method is that it considers recharge and discharge simultaneously, whereas the general WTF methods mostly focus on recharge. In the case study, the infiltration efficiency reveals that the infiltration is regionally controlled by the intrinsic characteristics of the aquifer, and locally distorted by engineered hydraulic structures that alter surface water-groundwater interactions. The seasonality of groundwater discharge is characterized by the monthly discharge modulus. These results from individual wells are clustered into groups that are consistent with the local land use pattern and cropping structures.

  14. Risk Factors Associated With Survival to Hospital Discharge of 54 Horses With Fractures of the Radius.

    Science.gov (United States)

    Stewart, Suzanne; Richardson, Dean; Boston, Ray; Schaer, Thomas P

    2015-11-01

    To determine (1) survival to discharge of horses with radial fractures (excluding osteochondral fragmentation of the distal aspect of the radius and stress fractures); and (2) risk factors affecting survival to hospital discharge in conservative and surgically managed fractures. Case series. Horses (n = 54). Medical records (1990-June 2012) and radiographs of horses admitted with radial fracture were reviewed. Horses with osteochondral fragmentation of the distal aspect of the radius or stress fractures were excluded. Evaluated risk factors were age, fracture configuration, surgical repair method, surgical duration, hospitalization time, implant failure rate, and surgical site infection (SSI) rate. Of 54 horses, overall survival to discharge was 50%. Thirteen (24%) were euthanatized on admission because of (1) fracture severity; (2) presence of an open fracture; or (3) financial constraints. Fourteen (26%) horses with minimally displaced incomplete fractures were conservatively managed and 12 (86%) survived to discharge. Twenty-seven (50%) horses had surgical treatment by open reduction and internal fixation (ORIF) and 15 (56%) survived to hospital discharge. Open fractures were significantly more likely to develop SSI (P = .008), which also resulted in a 17-fold increase in implant failure (P horses with an open fracture did not survive to discharge. Outcome was also adversely affected by age (P 168 minutes (P fractures is good. Young horses have a good prognosis survival to discharge for ORIF, whereas ORIF in adult horses has a poor prognosis and SSI strongly correlates with catastrophic implant failure. © Copyright 2015 by The American College of Veterinary Surgeons.

  15. The Role of Frozen Soil in Groundwater Discharge Predictions for Warming Alpine Watersheds

    Science.gov (United States)

    Evans, Sarah G.; Ge, Shemin; Voss, Clifford I.; Molotch, Noah P.

    2018-03-01

    Climate warming may alter the quantity and timing of groundwater discharge to streams in high alpine watersheds due to changes in the timing of the duration of seasonal freezing in the subsurface and snowmelt recharge. It is imperative to understand the effects of seasonal freezing and recharge on groundwater discharge to streams in warming alpine watersheds as streamflow originating from these watersheds is a critical water resource for downstream users. This study evaluates how climate warming may alter groundwater discharge due to changes in seasonally frozen ground and snowmelt using a 2-D coupled flow and heat transport model with freeze and thaw capabilities for variably saturated media. The model is applied to a representative snowmelt-dominated watershed in the Rocky Mountains of central Colorado, USA, with snowmelt time series reconstructed from a 12 year data set of hydrometeorological records and satellite-derived snow covered area. Model analyses indicate that the duration of seasonal freezing in the subsurface controls groundwater discharge to streams, while snowmelt timing controls groundwater discharge to hillslope faces. Climate warming causes changes to subsurface ice content and duration, rerouting groundwater flow paths but not altering the total magnitude of future groundwater discharge outside of the bounds of hydrologic parameter uncertainties. These findings suggest that frozen soil routines play an important role for predicting the future location of groundwater discharge in watersheds underlain by seasonally frozen ground.

  16. The role of frozen soil in groundwater discharge predictions for warming alpine watersheds

    Science.gov (United States)

    Evans, Sarah G.; Ge, Shemin; Voss, Clifford I.; Molotch, Noah P.

    2018-01-01

    Climate warming may alter the quantity and timing of groundwater discharge to streams in high alpine watersheds due to changes in the timing of the duration of seasonal freezing in the subsurface and snowmelt recharge. It is imperative to understand the effects of seasonal freezing and recharge on groundwater discharge to streams in warming alpine watersheds as streamflow originating from these watersheds is a critical water resource for downstream users. This study evaluates how climate warming may alter groundwater discharge due to changes in seasonally frozen ground and snowmelt using a 2‐D coupled flow and heat transport model with freeze and thaw capabilities for variably saturated media. The model is applied to a representative snowmelt‐dominated watershed in the Rocky Mountains of central Colorado, USA, with snowmelt time series reconstructed from a 12 year data set of hydrometeorological records and satellite‐derived snow covered area. Model analyses indicate that the duration of seasonal freezing in the subsurface controls groundwater discharge to streams, while snowmelt timing controls groundwater discharge to hillslope faces. Climate warming causes changes to subsurface ice content and duration, rerouting groundwater flow paths but not altering the total magnitude of future groundwater discharge outside of the bounds of hydrologic parameter uncertainties. These findings suggest that frozen soil routines play an important role for predicting the future location of groundwater discharge in watersheds underlain by seasonally frozen ground.

  17. Origin of fin-clipped salmonids collected at two thermal discharges on Lake Michigan

    International Nuclear Information System (INIS)

    Romberg, G.P.; Thommes, M.M.; Spigarelli, S.A.

    1974-01-01

    Fin clips observed on fish collected during tagging studies at the Point Beach and Waukegan thermal discharges were recorded and the data were tabulated by species. Using fin clip and fish size, attempts were made to identify probable stocking locations and dates from agency records. Data are presented for lake trout, rainbow trout, brown trout, and Coho salmon. Tables are presented to show probable stocking locations and dates

  18. Investigation of atmospheric dielectric barrier discharge and its application to surface modification of textile material

    International Nuclear Information System (INIS)

    Xiaoliang Tang; Gao Qiu; Hankun Xie; Xianping Feng

    2005-01-01

    The dielectric barrier discharge (DBD) is characterized by the presence of at least one insulating layer in contact with the discharge between two planar or cylindrical electrodes connected to an ac power supply. In this paper, the spectral lines of plasma emission at atmospheric pressure were recorded by using a grating spectrograph, and all signals will be directly and immediately sent to the computer for data processing and analysis during the experiments. The spectrum lines of nitrogen, helium and argon plasma emission at atmospheric pressure were separately recorded and qualitatively analyzed using spectral diagnosis equipment of atmospheric pressure DBD plasma. The spectrum lines of the second positive system of nitrogen (c 3 π μ → B 3 Π g ), two characteristic spectrum lines of helium (3 1 P 1 → 2 1 S 0 , 3 3 D → 3 3 P), and all of neutral argon atom spectrum lines in the range 680 to 780 nm are recognized. For controlling the process of material surface modification promptly, the electron temperature of DBD plasma is quantitatively analyzed using relative intensity of argon spectrum lines. The relationships among the plasma parameters, such as discharge current and discharge power measured by Lissajous figure of the oscilloscope, were analyzed by using improved DBD equipment. The variation of plasma discharge current following the change of discharge gaps indicates an existence of critical gap distance. When the gap between electrodes is less than that the critical gap, a quasi-stable atmospheric pressure DBD plasma source can be achieved after carefully controlled discharge voltage and current. The experimental results indicate that a critical discharge gap is an important parameter to improve the quality of materials processing. The result is of great importance to DBD at atmospheric pressure and its application to materials processing. (author)

  19. Maximum Acceleration Recording Circuit

    Science.gov (United States)

    Bozeman, Richard J., Jr.

    1995-01-01

    Coarsely digitized maximum levels recorded in blown fuses. Circuit feeds power to accelerometer and makes nonvolatile record of maximum level to which output of accelerometer rises during measurement interval. In comparison with inertia-type single-preset-trip-point mechanical maximum-acceleration-recording devices, circuit weighs less, occupies less space, and records accelerations within narrower bands of uncertainty. In comparison with prior electronic data-acquisition systems designed for same purpose, circuit simpler, less bulky, consumes less power, costs and analysis of data recorded in magnetic or electronic memory devices. Circuit used, for example, to record accelerations to which commodities subjected during transportation on trucks.

  20. Nitrate retention in a sand plains stream and the importance of groundwater discharge

    Science.gov (United States)

    Robert S. Stelzer; Damion R. Drover; Susan L. Eggert; Maureen A. Muldoon

    2011-01-01

    We measured net nitrate retention by mass balance in a 700-m upwelling reach of a third-order sand plains stream, Emmons Creek, from January 2007 to November 2008. Surface water and ground-water fluxes of nitrate were determined from continuous records of discharge and from nitrate concentrations based on weekly and biweekly sampling at three surface water stations and...