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Sample records for model patients carrying

  1. Which melanoma patient carries a BRAF-mutation? A comparison of predictive models

    Science.gov (United States)

    Eigentler, Thomas; Assi, Zeinab; Hassel, Jessica C.; Heinzerling, Lucie; Starz, Hans; Berneburg, Mark; Bauer, Jürgen; Garbe, Claus

    2016-01-01

    Background In patients with advanced melanoma the detection of BRAF mutations is considered mandatory before the initiation of an expensive treatment with BRAF/MEK inhibitors. Sometimes it is difficult to perform such an analysis if archival tumor tissue is not available and fresh tissue has to be collected. Results 514 of 1170 patients (44%) carried a BRAF mutation. All models revealed age and histological subtype of melanoma as the two major predictive variables. Accuracy ranged from 0.65–0.71, being best in the random forest model. Sensitivity ranged 0.76–0.84, again best in the random forest model. Specificity was low in all models ranging 0.51–0.55. Methods We collected the clinical data and mutational status of 1170 patients with advanced melanoma and established three different predictive models (binary logistic regression, classification and regression trees, and random forest) to forecast the BRAF status. Conclusions Up to date statistical models are not able to predict BRAF mutations in an acceptable accuracy. The analysis of the mutational status by sequencing or immunohistochemistry must still be considered as standard of care. PMID:27150060

  2. Carry

    DEFF Research Database (Denmark)

    Koijen, Ralph S.J.; Moskowitz, Tobias J.; Heje Pedersen, Lasse;

    that include global equities, global bonds, currencies, commodities, US Treasuries, credit, and equity index options. This predictability underlies the strong returns to "carry trades" that go long high-carry and short low-carry securities, applied almost exclusively to currencies, but shown here...

  3. Error propagation in energetic carrying capacity models

    Science.gov (United States)

    Pearse, Aaron T.; Stafford, Joshua D.

    2014-01-01

    Conservation objectives derived from carrying capacity models have been used to inform management of landscapes for wildlife populations. Energetic carrying capacity models are particularly useful in conservation planning for wildlife; these models use estimates of food abundance and energetic requirements of wildlife to target conservation actions. We provide a general method for incorporating a foraging threshold (i.e., density of food at which foraging becomes unprofitable) when estimating food availability with energetic carrying capacity models. We use a hypothetical example to describe how past methods for adjustment of foraging thresholds biased results of energetic carrying capacity models in certain instances. Adjusting foraging thresholds at the patch level of the species of interest provides results consistent with ecological foraging theory. Presentation of two case studies suggest variation in bias which, in certain instances, created large errors in conservation objectives and may have led to inefficient allocation of limited resources. Our results also illustrate how small errors or biases in application of input parameters, when extrapolated to large spatial extents, propagate errors in conservation planning and can have negative implications for target populations.

  4. The logistic model-generated carrying capacities for wild herbivores ...

    African Journals Online (AJOL)

    Jesse

    Modelled as discrete-time logistic equations with fixed carrying capacities, it captures the wildlife herbivore population dynamics. Time series data, covering a period ..... Building Models for Conservation and. Wildlife Management. (New York ...

  5. Model Modification and Application on Carrying Capacity of Relative Resources

    Institute of Scientific and Technical Information of China (English)

    Li Zehong; Dong Suocheng; Gao Dan

    2009-01-01

    Based on the retrospection of researches on carry-ing capacity, this article reviewed systematically the research progresses on carrying capacity of relative resources (CCRR).Then the viewpoint was put forward that CCRR is not an ap-propriate method of appraising the regional sustainability, but a sound way to obtain cognition for coordinating spatial loca-tion and flow of population and economy.However, as the most popular computing method of CCRR, the Weighting Linear Sum Model is defective in the random of weight choice and the neglect of matching among different resources.Therefore, this article established the Geometric Model on CCRR based on modifying Weighting Linear Sum Model, which can be used to appraise regions where resources are close matching.Em-ploying the Geometric Model, the article empirically analyzed the population and economic CCRR in Hubei Province from 1978 to 2006.The result indicates that the population in Hubei Province is overloading while the economic carrying capacity is abundant compared to the whole country, and the economic insufficiency restricts the population carrying capacity.In the future, Hubei Province will become one of the core developing zones which are characterized by economic conglomeration.

  6. Description of Model Tests Carried Out by Aalborg University

    DEFF Research Database (Denmark)

    Frigaard, Peter; Schlütter, F.; Andersen, H.

    1996-01-01

    As associated partner, Aalborg University (AU) have participated in different aspects of "the Zeebrugge project". AU has carried out an extensive number of small-scale model tests (1:65) with the Zeebrugge breakwater with the aim of investigating scale-effects.......As associated partner, Aalborg University (AU) have participated in different aspects of "the Zeebrugge project". AU has carried out an extensive number of small-scale model tests (1:65) with the Zeebrugge breakwater with the aim of investigating scale-effects....

  7. Hierarchical population model with a carrying capacity distribution

    CERN Document Server

    Indekeu, J O

    2002-01-01

    A time- and space-discrete model for the growth of a rapidly saturating local biological population $N(x,t)$ is derived from a hierarchical random deposition process previously studied in statistical physics. Two biologically relevant parameters, the probabilities of birth, $B$, and of death, $D$, determine the carrying capacity $K$. Due to the randomness the population depends strongly on position, $x$, and there is a distribution of carrying capacities, $\\Pi (K)$. This distribution has self-similar character owing to the imposed hierarchy. The most probable carrying capacity and its probability are studied as a function of $B$ and $D$. The effective growth rate decreases with time, roughly as in a Verhulst process. The model is possibly applicable, for example, to bacteria forming a "towering pillar" biofilm. The bacteria divide on randomly distributed nutrient-rich regions and are exposed to random local bactericidal agent (antibiotic spray). A gradual overall temperature change away from optimal growth co...

  8. Modeling the Flexural Carrying Capacity of Corroded RC Beam

    Institute of Scientific and Technical Information of China (English)

    WANG Xiao-hui; LIU Xi-la

    2008-01-01

    Considering the change of bond strength between corroded steel and concrete, flexural carrying ca-pacity of corroded reinforced concrete (RC) beam was calculated. On the basis of the condition of equilibriumof forces and compatibility of deformations for the whole beam, a model for the prediction of flexural carryingcapacity of the corroded RC beam was proposed. Comparison of the model's predictions with the experimentalresults published in the literature shows the practicality of the proposed method.

  9. Modelling of carry-over in recovery furnaces

    Energy Technology Data Exchange (ETDEWEB)

    Fakhrai, Reza [Royal Inst. of Tech., Stockholm (Sweden). Dept. of Metallurgy

    2000-04-01

    Development of mathematical modelling of the combustion process in the furnace of recovery boilers is the subject of this work. This work as a continuation of many years of modelling efforts carried out at KTH/Vaerme- och Ugnsteknik focussed particularly on: char bed modelling; droplets-wall interaction modelling; and carry-over modelling. The char bed model has been studied. Droplets/parcels were considered as a single reactor working independently of the other droplets. The mass of the droplets was not distributed uniformly but induced in the landing place. The droplets hitting the char bed will stick to it and they are alive and part of the calculation. In this way the distribution of the mass on the char bed is only dependent on the parameters which effect flight history such as droplet/parcel diameter, boilers flow field, etc. The droplet- wall interaction model has been studied and found to be very important for obtaining the correct temperature distribution in the recovery furnace. The new approach is based on removal of droplets which hits the wall in the upper part of the recovery boiler from carryover calculation. This model has been proposed and implemented into the GRFM (General Recovery Furnace Model). The carryover modelling effort was based on mass balance in which the number and physical statistics of the droplets/parcel were estimated and the amount of unburned mass was calculated. All of the above listed models were tested together with all other models of heat and mass transfer processes in recovery furnaces using a GRFM. Three-dimensional numerical simulations of the industrial recovery boiler (63 kg/s, 82 bar, 480 deg C) were performed. The number of grid was 232,000 and the number of air ports in this simulation was 178. The air entering the furnace by these ports has different flow rates. Flow and temperature fields as well as species distributions were calculated. The results show good agreement with previously published data and modelling

  10. Modeling symbiosis by interactions through species carrying capacities

    Science.gov (United States)

    Yukalov, V. I.; Yukalova, E. P.; Sornette, D.

    2012-08-01

    We introduce a mathematical model of symbiosis between different species by taking into account the influence of each species on the carrying capacities of the others. The modeled entities can pertain to biological and ecological societies or to social, economic and financial societies. Our model includes three basic types: symbiosis with direct mutual interactions, symbiosis with asymmetric interactions, and symbiosis without direct interactions. In all cases, we provide a complete classification of all admissible dynamical regimes. The proposed model of symbiosis turned out to be very rich, as it exhibits four qualitatively different regimes: convergence to stationary states, unbounded exponential growth, finite-time singularity, and finite-time death or extinction of species.

  11. Filaggrin compound heterozygous patients carry mutations in trans position

    DEFF Research Database (Denmark)

    Carlsen, Berit C; Meldgaard, Michael; Johansen, Jeanne D

    2013-01-01

    ; however, this has not been scientifically investigated. Two different FLG null mutations in the same individual may be in trans position, meaning that each mutation locates to a different allele functionally equivalent to homozygosity, or may be in cis position, meaning that both mutations locate...... to the same allele functionally equivalent to heterozygosity. To experimentally investigate allelic in cis versus in trans configuration of the two most common filaggrin (FLG) mutations (R501X and 2282del4) in compound heterozygous individuals. Testing for in cis or in trans allele configuration was performed...... compound heterozygous individuals were found to carry the two mutations in trans position. FLG null mutation compound heterozygous individuals can be considered functionally equivalent to FLG null mutation homozygosity for any of the two mutations....

  12. Pollitt syndrome patients carry mutation in TTDN1

    Directory of Open Access Journals (Sweden)

    Sigrid M.A. Swagemakers

    2014-12-01

    Full Text Available Complete human genome sequencing was used to identify the causative mutation in a family with Pollitt syndrome (MIM #275550, comprising two non-consanguineous parents and their two affected children. The patient's symptoms were reminiscent of the non-photosensitive form of recessively inherited trichothiodystrophy (TTD. A mutation in the TTDN1/C7orf11 gene, a gene that is known to be involved in non-photosensitive TTD, had been excluded by others by Sanger sequencing. Unexpectedly, we did find a homozygous single-base pair deletion in the coding region of this gene, a mutation that is known to cause non-photosensitive TTD. The deleterious variant causing a frame shift at amino acid 93 (C326delA followed the right mode of inheritance in the family and was independently validated using conventional DNA sequencing. We expect this novel DNA sequencing technology to help redefine phenotypic and genomic variation in patients with (mono genetic disorders in an unprecedented manner.

  13. The importance of carrying a backpack in the rehabilitation of osteoporotic patients (biomechanical analysis).

    Science.gov (United States)

    Wendlova, J

    2011-01-01

    Based on a simple biomechanical analysis available to physicians, the article recommends carrying a backpack regularly as a part of the complex rehabilitation of osteoporotic patients. Carrying a backpack in front or on the back is recommended to patients with uncomplicated osteoporosis, while carrying a backpack on the back only is recommended to patients with osteporotic vertebral fractures. The importance of carrying a backpack is based upon removing the muscular dysbalance of the trunk muscles and upon increasing the bone strength by compressive force acting upon the vertebrae and proximal femur and activating osteoblasts to enhance the process of osteoformation. The backpack load is differentiated--patients with vertebral fractures put a weight up to 1 kg into their backpacks, patients without vertebral fractures increase the load up to 2 kg (Fig. 2, Ref. 12).

  14. Clinical features of Chinese patients with Huntington's disease carrying CAG repeats beyond 60 within HTT gene.

    Science.gov (United States)

    Liu, Z-J; Sun, Y-M; Ni, W; Dong, Y; Shi, S-S; Wu, Z-Y

    2014-02-01

    Patients with Huntington's disease (HD) carrying CAG repeats beyond 60 are less frequently seen and clinical features of them have been rarely reported. We identified four unrelated patients carrying CAG repeats beyond 60 (84.0 ± 13.76, ranging from 74 to 104) from 119 Chinese HD patients via direct sequencing. These four were all early onset with a mean age at presenting symptom of 9.8 ± 1.71 years. Paternal transmission was found in three of them and the fourth was apparently sporadic. In addition, they had atypical onset symptoms including epilepsy, intellectual decline, tics and walking instability, which might lead the clinicians to make the wrong diagnosis in the early stage of disease. Our work explores clinical features of Chinese HD patients with an expanded CAG repeat over 60 and may help the clinicians make a correct diagnosis in the early stage of disease.

  15. TNF-alpha levels are not increased in inflamed patients carrying the CCR5 deletion 32

    NARCIS (Netherlands)

    Muntinghe, Friso L. H.; Carrero, Juan Jesus; Navis, Gerjan; Stenvinkel, Peter

    2011-01-01

    Background and aims: Recently we reported on a genetically predisposed protection from C-reactive protein (CRP) related mortality in dialysis patients carrying the functional CC-chemokine receptor 5 deletion 32 allele (CCR5 Delta 32) mutation. Since CCR5 Delta 32 is associated with a less pro-inflam

  16. First Identification of a Patient Colonized With Klebsiella pneumoniae Carrying blaNDM-1 in Taiwan

    Directory of Open Access Journals (Sweden)

    Hua-Shin Wu

    2010-11-01

    Full Text Available New Delhi metallo-β-lactamase 1 (NDM-1 is a novel type of metallo-β-lactamase (MBL. Enterobacteriaceae carrying this NDM-1 encoding gene, blaNDM-1, have been identified worldwide. Bacteria carrying blaNDM-1 are not only resistant to carbapenem, but also highly resistant to many classes of antibiotics, which indicate the importance of prompt identification of these bacteria and implementation of strict infection control measures to prevent their transmission. Here, we report the first identification and management of a patient colonized with Klebsiella pneumoniae carrying blaNDM-1 in Taiwan, who returned from New Delhi where he had been hospitalized for a gun-shot injury.

  17. Synchronisation of fertility with carrying capacity; an investigation using classical and agent based modeling

    Directory of Open Access Journals (Sweden)

    Hugh Crozier Murrell

    2013-05-01

    Full Text Available A generalized Verhulst model subject to seasonal change in both fertility rate and carrying capacity is outlined. Numerical solutions to the Verhulst equations are employed to obtain optimal fertility rate phase shift with respect to carrying capacity. Possible natural selection for a preferred season of conception is investigated using agent based simulations. Both experiments indicate that synchronization of fertility rate to environment carrying capacity is beneficial to species survival.

  18. Effects of a Fluctuating Carrying Capacity on the Generalized Malthus-Verhulst Model

    OpenAIRE

    Héctor Calisto; Chandía, Kristopher J.; Mauro Bologna

    2014-01-01

    We consider a generalized Malthus-Verhulst model with a fluctuating carrying capacity and we study its effects on population growth. The carrying capacity fluctuations are described by a Poissonian process with an exponential correlation function. We will find an analytical expression for the average of a number of individuals and show that even in presence of a fluctuating carrying capacity the average tends asymptotically to a constant quantity.

  19. Effects of a Fluctuating Carrying Capacity on the Generalized Malthus-Verhulst Model

    Directory of Open Access Journals (Sweden)

    Héctor Calisto

    2014-01-01

    Full Text Available We consider a generalized Malthus-Verhulst model with a fluctuating carrying capacity and we study its effects on population growth. The carrying capacity fluctuations are described by a Poissonian process with an exponential correlation function. We will find an analytical expression for the average of a number of individuals and show that even in presence of a fluctuating carrying capacity the average tends asymptotically to a constant quantity.

  20. The application of a phosphorus mass balance model for estimating the carrying capacity of Lake Kariba

    OpenAIRE

    MHLANGA, Lindah; MHLANGA, Wilson; MWERA, Paul

    2013-01-01

    The aim of this study was to use an empirical mass balance equation to estimate the carrying capacity of Lake Kariba, where cage culture for Nile tilapia Oreochromis niloticus has been practiced since 1996. The carrying capacity for the lake was estimated at 33.2 × 103 t per year using the Dillon-Rigler phosphorus budget model.

  1. A model to estimate aquaculture carrying capacity in three areas of the Philippines

    Directory of Open Access Journals (Sweden)

    Tarzan Legović

    2008-12-01

    Full Text Available A model was developed to estimate the production carrying capacity of water bodies based on nutrient inputs from aquaculture and other sources, flushing rates, and the risk of algal blooms for three different areas of the Philippines – Bolinao (marine site, Dagupan (brackishwater site and Taal Lake (freshwater site. The results suggest that aquaculture production in the Taal Lake was greater than the sustainable carrying capacity. Aquaculture structures in Bolinao were close to carrying capacity during average tidal exchange but greater than the carrying capacity during low tidal exchange and no winds.Aquaculture production in the Dagupan estuary has not overcome its carrying capacity even during low flow. However, during very low flow and no tidal flushing, carrying capacity has been overcome.

  2. [Advance euthanasia directives in dementia rarely carried out. Qualitative study in physicians and patients].

    Science.gov (United States)

    Rurup, Mette L; Pasman, H R W Roeline; Onwuteaka-Philipsen, Bregje D

    2010-01-01

    To study how advance euthanasia directives (AEDs) in dementia are viewed in practice in the Netherlands. Qualitative study. In-depth interviews on nine patients with the patients themselves and/or partners and their physicians. The patients were included from a cohort of people with an AED. All interviews were done in 2006. Cases were included with different diagnoses and at different stages of dementia. Interviewed patients and their relatives had very high expectations of the feasibility of the AED. Interviewed physicians often thought of AEDs as aids in starting up a dialogue about medical decisions at the end of life, but they did not always do this in practice. Most physicians were open to adhering to AEDs in exceptional cases, on condition that the patient obviously suffered, and that communication with the patient to some extent was possible. In this study two cases were found in which adhering to the AED was seriously considered. In one case, fear of legal consequences was the only reason the physician had not adhered to the AED, while it seemed all the requirements of due care could be met. Euthanasia was not carried out in the other patient either. Several physicians mentioned the need for more detailed practical guidelines for the use of AEDs for dementia. Patients had too high expectations of AEDs. It seemed that in exceptional cases the requirements for due care for euthanasia can be met in patients with dementia with an AED. It seems advisable that more detailed practical guidelines for the use of AEDs in cases of dementia be drawn up, as a first step to more clarity for patients and physicians.

  3. Quantifying spatially derived carrying capacity occupation: Framework for characterisation modelling and application to terrestrial acidification

    DEFF Research Database (Denmark)

    Bjørn, Anders; Margni, M.; Bulle, C.

    *year. This metric resembles that of the ecological footprint method and may be compared to the availability of land or water. The framework was applied to the terrestrial acidification impact category. The geochemical steady-state model PROFILE was used to quantify carrying capacities as deposition levels......The popularity of the ecological footprint method and the planetary boundaries concept shows an increasing interest among decision makers in comparing environmental impacts to carrying capacities of natural systems. Recently carrying capacity-based normalisation references were developed for impact...

  4. Estimating the carrying capacity of green mussel cultivation by using net nutrient removal model.

    Science.gov (United States)

    Srisunont, Chayarat; Babel, Sandhya

    2016-11-15

    This study aims to evaluate the nutrient removal potential and carrying capacity of green mussel cultivation by using the mass balance model. The developed model takes into consideration the green mussel growth rate, density and chlorophyll a concentration. The data employed in this study were based on culture conditions at Sriracha Fisheries Research Station, Thailand. Results show that net nutrient removal by green mussel is 3302, 380, and 124mg/year/indv for carbon, nitrogen, and phosphorus respectively. The carrying capacity of green mussel cultivation was found to be 300indv/m(2) based on chlorophyll a concentration which will not release phosphorus in the water environment beyond the standard (45μg-PO4(-3)-P/L). Higher chlorophyll a concentration results in lowered green mussel carrying capacity. This model can assist farm operators with possible management strategies for a sustainable mussel cultivation and protection of the marine environment.

  5. A patient with pseudohypoaldosteronism type II complicated by congenital hypopituitarism carrying a KLHL3 mutation

    Science.gov (United States)

    Mitani, Marie; Furuichi, Munehiro; Narumi, Satoshi; Hasegawa, Tomonobu; Chiga, Motoko; Uchida, Shinichi; Sato, Seiji

    2016-01-01

    Abstract. Pseudohypoaldosteronism type II (PHA II) is a renal tubular disease that causes hyperkalemia, hypertension, and metabolic acidosis. Mutations in four genes (WNK4, WNK1, KLHL3, and CUL3) are known to cause PHA II. We report a patient with PHA II carrying a KLHL3 mutation, who also had congenital hypopituitarism. The patient, a 3-yr-old boy, experienced loss of consciousness at age 10 mo. He exhibited growth failure, hypertension, hyperkalemia, and metabolic acidosis. We diagnosed him as having PHA II because he had low plasma renin activity with normal plasma aldosterone level and a low transtubular potassium gradient. Further investigations revealed defective secretion of GH and gonadotropins and anterior pituitary gland hypoplasia. Genetic analyses revealed a previously known heterozygous KLHL3 mutation (p.Leu387Pro), but no mutation was detected in 27 genes associated with congenital hypopituitarism. He was treated with sodium restriction and recombinant human GH, which normalized growth velocity. This is the first report of a molecularly confirmed patient with PHA II complicated by congenital hypopituitarism. We speculate that both GH deficiency and metabolic acidosis contributed to growth failure. Endocrinological investigations will help to individualize the treatment of patients with PHA II presenting with growth failure. PMID:27780982

  6. Momentum Fractions carried by quarks and gluons in models of proton structure functions at small $x$

    CERN Document Server

    Choudhury, D K; Kalita, K

    2016-01-01

    The paper reports analysis of momentum fractions carried by quarks and gluons in models of Proton structure functions at small $x$. First, we analyze the model proposed by Lastovicka based on self-similarity sometime back. We then make a similar analysis for a second model based on the same notion which is also free from singularity in $x$ : $0models are then compared with a recent QCD based Froissart bound compatible model of proton structure function at small $x$, suggested by Block, Durand, Ha and McKay. The results are then compared with the corresponding study in perturbative and Lattice QCD.

  7. Overlap syndrome between FMF and TRAPS in a patient carrying MEFV and TNFRSF1A mutations.

    Science.gov (United States)

    Granel, B; Serratrice, J; Dodé, C; Grateau, G; Disdier, P; Weiller, P-J

    2007-01-01

    Familial Mediterranean Fever (FMF) and TNF-Receptor Associated Periodic Syndrome (TRAPS) are two inheritable inflammatory disorders. They share some clinical manifestations but their treatments are different. We present here the case of an overlap syndrome of FMF and TRAPS in a patient carrying a mutation in both the MEFV and TNFRSF1A genes. A 20-year-old woman of Mediterranean origin had suffered since childhood from attacks of fever and arthritis, with skin and ophthalmic manifestations. The initial diagnosis was FMF. The symptoms responded poorly to colchicine but regressed with steroids. Genetic analysis revealed a homozygous M694V mutation in MEFV and a heterozygous R92Q mutation in TNFRSF1A. We discuss the complexity of this combined FMF-TRAPS phenotype. This case shows that mutations in MEFV and TNFRSF1A can occur together in a single patient, a condition that may modify its response to treatment. It would be interesting to evaluate the role of the R92Q mutation in TNFRSF1A in patients of Mediterranean origin with FMF unresponsive to colchicine.

  8. Train Headway Models and Carrying Capacity of Super-Speed Maglev System

    Science.gov (United States)

    He, Shiwei; Song, Rui; Eastham, Tony

    Train headway models are established by analyzing the operation of the Transrapid Super-speed Maglev System (TSMS). The variation in the minimum allowable headway for trains of different speeds and consists is studied under various operational constraints. A potential Beijing-Shanghai Maglev line is used as an illustration to undertake capacity analyses with the model and methods. The example shows that the headway models for analyzing the carrying capacity of Maglev systems are very useful for the configurational design of this new transport system.

  9. Fuzzy Comprehensive Evaluation Model for Water Resources Carrying Capacity in Tarim River Basin, Xinjiang, China

    Institute of Scientific and Technical Information of China (English)

    MENG Lihong; CHEN Yaning; LI Weihong; ZHAO Ruifeng

    2009-01-01

    This paper explores the method of comprehensive evaluation of water resources carrying capacity and sets up an evaluation model applying the fuzzy comprehensive evaluation method. Based on the data of nature, society, economics and water resources of the Tarim River Basin in 2002, we evaluated the water resources carrying capacity of the basin by means of the model. The results show that the comprehensive grades are 0.438 and 0.454 for Aksu and Kashi prefectures respectively, where the current water resources exploitation and utilization has reached a relative high degree and there is only a very limited water carrying capacity, 0.620 for Kizilsu Kirgiz Autonomous Prefecture, where water resources carrying capacity is much higher, and in between for Hotan Prefecture and Bayingolin Mongolian Autonomous Prefecture. As a whole, the comprehensive grade of the Tarim River Basin is 0.508 and the current water resources exploitation and utilization has reached a relative high degree. Thus, we suggest that the integrated management of the water resources in the basin should be strengthened in order to utilize water resources scientifically and sustainably.

  10. Drug-resistant genes carried by Acinetobacter baumanii isolated from patients with lower respiratory tract infection

    Institute of Scientific and Technical Information of China (English)

    DAI Ning; ZHANG Wei; LI Jia-shu; YU Qin; WAN Huan-ying; MU Lan; ZHONG Xiao-ning; WEI Li-ping; MA Jian-jun; WANG Qiu-yue; HU Ke; LI De-zhi; TIAN Gui-zhen; CAI Shao-xi; WANG Rui-qin; HE Bei; WANG Si-qin; WANG Zhan-wei; ZHAO Su-rui; GAO Zhan-cheng; CHEN Ji-chao; CHEN Yu-sheng; GENG Rong; HU Ying-hui; YANG Jing-ping; DU Juan; HU Cheng-ping

    2010-01-01

    Background Acinetobacter baumanii (A. baumanii) remains an important microbial pathogen resulting in nosocomial acquired infections with significant morbidity and mortality. The mechanism by which nosocomial bacteria, like A.baumanii, attain multidrug resistance to antibiotics is of considerable interest. The aim in this study was to investigate the spread status of antibiotic resistance genes, such as multiple β-lactamase genes and aminoglycoside-modifying enzyme genes, from A. baumanii strains isolated from patients with lower respiratory tract infections (LRTIs).Methods Two thousand six hundred and ninety-eight sputum or the bronchoalveolar lavage samples from inpatients with LRTIs were collected in 21 hospitals in the mainland of China from November 2007 to February 2009. All samples were routinely inoculated. The isolated bacterial strains and their susceptibility were analyzed via VITEK-2 expert system.Several kinds of antibiotic resistant genes were further differentiated via polymerase chain reaction and sequencing methods.Results Totally, 39 A. baumanii strains were isolated from 2698 sputum or bronchoalveolar lavage samples. There was not only a high resistant rate of the isolated A. baumanii strains to ampicillin and first- and second-generation cephalosporins (94.87%, 100% and 97.44%, respectively), but also to the third-generation cephalosporins (ceftriaxone at 92.31%, ceftazidine at 51.28%) and imipenem (43.59%) as well. The lowest antibiotic resistance rate of 20.51% was found to amikacin. The OXA-23 gene was identified in 17 strains of A. baumanii, and the AmpC gene in 23 strains. The TEM-1 gene was carried in 15 strains. PER-1 and SHV-2 genes were detected in two different strains.Aminoglycoside-modifying enzyme gene aac-3-la was found in 23 strains, and the aac-6'-lb gene in 19 strains, aac-3-la and aac-6'-lb genes hibernated in three A. baumanii strains that showed no drug-resistant phenotype.Conclusions A. baumaniican carry multiple drug

  11. System dynamics model of Suzhou water resources carrying capacity and its application

    Directory of Open Access Journals (Sweden)

    Li CHENG

    2010-06-01

    Full Text Available A model of Suzhou water resources carrying capacity (WRCC was set up using the method of system dynamics (SD. In the model, three different water resources utilization programs were adopted: (1 continuity of existing water utilization, (2 water conservation/saving, and (3 water exploitation. The dynamic variation of the Suzhou WRCC was simulated with the supply-decided principle for the time period of 2001 to 2030, and the results were characterized based on socio-economic factors. The corresponding Suzhou WRCC values for several target years were calculated by the model. Based on these results, proper ways to improve the Suzhou WRCC are proposed. The model also produced an optimized plan, which can provide a scientific basis for the sustainable utilization of Suzhou water resources and for the coordinated development of the society, economy, and water resources.

  12. System dynamics model of Suzhou water resources carrying capacity and its application

    Institute of Scientific and Technical Information of China (English)

    Li CHENG

    2010-01-01

    A model of Suzhou water resources carrying capacity (WRCC) was set up using the method of system dynamics (SD).In the model, three different water resources utilization programs were adopted: (1) continuity of existing water utilization, (2) water conservation/saving, and (3) water exploitation.The dynamic variation of the Suzhou WRCC was simulated with the supply-decided principle for the time period of 2001 to 2030, and the results were characterized based on socio-economic factors.The corresponding Suzhou WRCC values for several target years were calculated by the model.Based on these results, proper ways to improve the Suzhou WRCC are proposed.The model also produced an optimized plan, which can provide a scientific basis for the sustainable utilization of Suzhou water resources and for the coordinated development of the society, economy, and water resources.

  13. Noise-Induced Transitions in a Population Growth Model Based on Size-Dependent Carrying Capacity

    Directory of Open Access Journals (Sweden)

    Neeme Lumi

    2014-01-01

    Full Text Available The stochastic dynamics of a population growth model with size-dependent carrying capacity is considered. The effect of a fluctuating environment on population growth is modeled as a multiplicative dichotomous noise. At intermediate values of population size the deterministic counterpart of the model behaves similarly to the Von Foerster model for human population, but at small and very large values of population size substantial differences occur. In the stochastic case, an exact analytical solution for the stationary probability distribution is found. It is established that variation of noise correlation time can cause noise-induced transitions between three different states of the system characterized by qualitatively different behaviors of the probability distributions of the population size. Also, it is shown that, in some regions of the system parameters, variation of the amplitude of environmental fluctuations can induce single unidirectional abrupt transitions of the mean population size.

  14. Thermal Model of a Current-Carrying Wire in a Vacuum

    Science.gov (United States)

    Border, James

    2006-01-01

    A computer program implements a thermal model of an insulated wire carrying electric current and surrounded by a vacuum. The model includes the effects of Joule heating, conduction of heat along the wire, and radiation of heat from the outer surface of the insulation on the wire. The model takes account of the temperature dependences of the thermal and electrical properties of the wire, the emissivity of the insulation, and the possibility that not only can temperature vary along the wire but, in addition, the ends of the wire can be thermally grounded at different temperatures. The resulting second-order differential equation for the steady-state temperature as a function of position along the wire is highly nonlinear. The wire is discretized along its length, and the equation is solved numerically by use of an iterative algorithm that utilizes a multidimensional version of the Newton-Raphson method.

  15. Induced pluripotent stem cells (iPSCs derived from cerebrotendinous xanthomatosis (CTX patient's fibroblasts carrying a R395S mutation

    Directory of Open Access Journals (Sweden)

    Philip Höflinger

    2016-09-01

    Full Text Available Induced pluripotent stem cells (iPSCs were generated from dermal fibroblasts from a 60-year-old cerebrotendinous xanthomatosis (CTX patient, carrying a homozygous mutation c. [1183C>A]; p. R395S in CYP27A1. Episomal plasmids encoding the pluripotency genes OCT4, SOX2, KLF4, L-MYC and LIN28 were introduced via electroporation. The generated line iPS-CTX-R395S has no sign of plasmid integration or chromosomal aberration and retained the mutation site in CYP27A1. Furthermore, iPSCs express pluripotency markers and are able to differentiate in all germ layers in vitro. The generated line may be a useful tool for disease modelling of CTX.

  16. Modeling of atmospheric iron processing carried by mineral dust and its deposition to ocean

    Science.gov (United States)

    Nickovic, Slobodan; Vukovic, Ana; Vujadinovic, Mirjam

    2014-05-01

    Relatively insoluble iron in dust originating from desert soils increases its solubility after Fe carried by mineral dust is chemically processed by the atmosphere. After dust is deposited deposition to the ocean, soluble Fe as a nutrient could enhance the marine primary production. The atmospheric dust cycle is driven by the atmospheric processes often of smaller, meso-scales. The soil mineralogy of dust emitted from sources determines also how much Fe in the aerosol will be finding. Once Fe is exposed to the atmospheric processes, the atmospheric radiation, clouds and polluted air will chemically affect the iron in dust. Global dust-iron models, having typical horizontal resolutions of 100-300 km which are mostly used to numerically simulate the fate of iron in the atmosphere can provide rather global picture of the dust and iron transport, but not details. Such models often introduce simplistic approximation on the Fe content in dust-productive soils. To simulate the Fe processing we instead implemented a high resolution regional atmospheric dust-iron model with detailed 1km global map for the geographic distribution of Fe content in soil. We also introduced a parameterization of the Fe processing caused by dust mineralogy, cloud processes and solar radiation. We will present results from simulation experiments in order to explore the model capability to reproduce major observed patterns of deposited Fe into the Atlantic cruises.

  17. A simplified model predicting the weight of the load carrying beam in a wind turbine blade

    Science.gov (United States)

    Mikkelsen, Lars P.

    2016-07-01

    Based on a simplified beam model, the loads, stresses and deflections experienced by a wind turbine blade of a given length is estimated. Due to the simplicity of the model used, the model is well suited for work investigating scaling effects of wind turbine blades. Presently, the model is used to predict the weight of the load carrying beam when using glass fibre reinforced polymers, carbon fibre reinforced polymers or an aluminium alloy as the construction material. Thereby, it is found that the weight of a glass fibre wind turbine blade is increased from 0.5 to 33 tons when the blade length grows from 20 to 90 m. In addition, it can be seen that for a blade using glass fibre reinforced polymers, the design is controlled by the deflection and thereby the material stiffness in order to avoid the blade to hit the tower. On the other hand if using aluminium, the design will be controlled by the fatigue resistance in order to making the material survive the 100 to 500 million load cycles experience of the wind turbine blade throughout the lifetime. The aluminium blade is also found to be considerably heavier compared with the composite blades.

  18. Carrying-over toxicokinetic model uncertainty into cancer risk estimates. The TCDD example

    Energy Technology Data Exchange (ETDEWEB)

    Edler, L. [Division of Biostatistics, German Cancer Research Center, Heidelberg (Germany); Heinzl, H.; Mittlboeck, M. [Medical Univ. of Vienna (Austria). Dept. of Medical Computer Sciences

    2004-09-15

    Estimation of human cancer risks depends on the assessment of exposure to the investigated hazardous compound as well as on its toxicokinetic and toxicodynamic in the body. Modeling these processes constitutes a basic prerequisite for any quantitative risk assessment including assessment of the uncertainty of risk estimates. Obviously, the modeling process itself is part of the risk assessment task, and it affects the development of valid risk estimates. Due to the wealth of information available on exposure and effects in humans and animals 2,3,7,8 tetrachlorodibenzo-pdioxin (TCDD) provides an excellent example to elaborate methods which allow a quantitative analysis of the uncertainty of TCDD risk estimates, and which show how toxicokinetic model uncertainty carries over to risk estimate uncertainty and uncertainty of the dose-response relationship. Cancer is usually considered as a slowly evolving disease. An increase in TCDD dose may result in an increase of the observable cancer response not until some latency time period has elapsed. This fact needs careful consideration when a dose-response relationship is to be established. Toxicokinetic models are capable to reconstruct TCDD exposure concentrations during a lifetime such that time-dependent TCDD dose metrics like the area under the concentration-time curve (AUC) can be constructed for each individual cohort member. Two potentially crucial model assumptions for estimating the exposure of a person are the assumption of lifetime constancy of total lipid volume (TLV) of the human body and the assumption of a simple linear kinetic of TCDD elimination. In 1995 a modified Michaelis-Menten kinetic (also known as Carrier kinetic) has been suggested to link the TCDD elimination rate to the available TCDD amount in the body. That is, TCDD elimination would be faster, of nearly the same rate, or slower under this kinetic than under a simple linear kinetic when the individual would be highly, moderately, or slightly

  19. Can the documented patient briefing be carried out with an iPad app?

    Science.gov (United States)

    Schlechtweg, Philipp Martin; Hammon, Matthias; Heberlein, Christian; Giese, David; Uder, Michael; Schwab, Siegfried Alexander

    2013-06-01

    To evaluate the feasibility of an iPad-based documented patient briefing for Magnetic Resonance Imaging (MRI) examinations. A standard briefing sheet and questionnaire for a MRI scan was converted from paper form into an iPad application. Twenty patients, who had been referred for an MRI scan, were briefed about the examination in paper form as well as via the iPad application before performing the MRI scan. Time each patient needed for the briefing and the number of questions that came up were documented. Patients' acceptance of the electronic briefing was assessed using a questionnaire. The mean processing time was 2.36 min (range 0.58 to 09.35 min., standard deviation ±2.05 min) for the paper-based briefing and 4.15 min (range 1.56 to 13.48 min, SD ± 2.36 min) for the app-based briefing. Concerning technical aspects, patients asked two questions during the app-based briefing; no questions arose during the paper-based briefing. Six patients preferred electronic briefing and four patients, the paper-based form. No patient preferred the electronic form with additional multimedial information. Eight participants did not mind which briefing version was used; two participants did not express their preference at all. Our experiences showed that electronic briefing using an iPad is feasible and has the potential to become a user-friendly alternative to the conventional paper-based approach. Owing to the broad range of the results, a follow-up study will seek to determine the influencing factors on processing time and other potential questions.

  20. Topiramate and visual loss in a patient carrying a Leber hereditary optic neuropathy mutation.

    Science.gov (United States)

    Rinalduzzi, Steno; Cipriani, Anna Maria; Accornero, Neri

    2012-04-01

    We describe a 43-year-old patient who experienced visual loss 4 years after beginning antiepileptic therapy with topiramate. Ophthalmological and neurological examinations led to a preliminary diagnosis of bilateral toxic optic neuritis. Mitochondrial genome sequence analysis detected a Leber hereditary optic neuropathy 11778G>A mutation. The possibility that topiramate might favor a conversion disease, alerts physicians to seek a history of blindness in patients undergoing chronic antiepileptic therapy.

  1. Clinical Features in Juvenile-Onset Ankylosing Spondylitis Patients Carrying Different B27 Subtypes

    Directory of Open Access Journals (Sweden)

    Yikun Mou

    2015-01-01

    Full Text Available Background. Ankylosing spondylitis (AS is a common rheumatic disease and is characterized by inflammation of the axial skeleton. HLA-B27 is strongly associated with AS. Juvenile-onset AS (JAS with disease onset before 16 years of age differs from adult-onset AS (AAS in many respects. Objective. To compare the clinical features in JAS with different B27 subtypes and analyze the differences between JAS and AAS. Methods. 145 JAS and 360 AAS patients were included. The demographic data, clinical manifestations, laboratory markers, Bath AS indices, and B27 subtypes were recorded. Results. Peripheral arthritis, enthesitis, BASDAI, ESR, and CRP were significantly higher in JAS patients with HLA-B*2704 than those with B27-negative. Enthesitis and ESR were significantly higher in patients with HLA-B*2705 than those with B27-negative. The onset age of HLA-B*2715 group was much earlier than the other groups. The peripheral arthritis, enthesitis, and hip joint involvement in JAS with HLA-B*2704 were significantly higher than those in AAS with HLA-B*2704. Conclusion. JAS with different B27 subtypes had similar features in most of manifestations; JAS and AAS patients with the same subtype could have distinctive courses. Early diagnosis, hip detection, and control of systemic active inflammation in JAS patients will be helpful for improving the prognosis.

  2. Generation and Characterization of a genetic zebrafish model of SMA carrying the human SMN2 gene

    Directory of Open Access Journals (Sweden)

    Beattie Christine E

    2011-03-01

    Full Text Available Abstract Background Animal models of human diseases are essential as they allow analysis of the disease process at the cellular level and can advance therapeutics by serving as a tool for drug screening and target validation. Here we report the development of a complete genetic model of spinal muscular atrophy (SMA in the vertebrate zebrafish to complement existing zebrafish, mouse, and invertebrate models and show its utility for testing compounds that alter SMN2 splicing. Results The human motoneuron disease SMA is caused by low levels, as opposed to a complete absence, of the survival motor neuron protein (SMN. To generate a true model of SMA in zebrafish, we have generated a transgenic zebrafish expressing the human SMN2 gene (hSMN2, which produces only a low amount of full-length SMN, and crossed this onto the smn-/- background. We show that human SMN2 is spliced in zebrafish as it is in humans and makes low levels of SMN protein. Moreover, we show that an antisense oligonucleotide that enhances correct hSMN2 splicing increases full-length hSMN RNA in this model. When we placed this transgene on the smn mutant background it rescued the neuromuscular presynaptic SV2 defect that occurs in smn mutants and increased their survival. Conclusions We have generated a transgenic fish carrying the human hSMN2 gene. This gene is spliced in fish as it is in humans and mice suggesting a conserved splicing mechanism in these vertebrates. Moreover, antisense targeting of an intronic splicing silencer site increased the amount of full length SMN generated from this transgene. Having this transgene on the smn mutant fish rescued the presynaptic defect and increased survival. This model of zebrafish SMA has all of the components of human SMA and can thus be used to understand motoneuron dysfunction in SMA, can be used as an vivo test for drugs or antisense approaches that increase full-length SMN, and can be developed for drug screening.

  3. Prophylactic Laparoscopic Total Gastrectomy with Jejunal Pouch Reconstruction in Patients Carrying a CDH1 Germline Mutation

    NARCIS (Netherlands)

    Haverkamp, L.; Sluis, P.C. van der; Ausems, M.G.; Horst, S. van der; Siersema, P.D.; Ruurda, J.P.; Offerhaus, G.J.; Hillegersberg, R. van

    2015-01-01

    BACKGROUND: For patients with an identified germline E-cadherin-1 (CDH1) mutation, prophylactic gastrectomy is the treatment of choice to eliminate the high risk of developing diffuse gastric cancer. Laparoscopic total gastrectomy with jejunal pouch reconstruction is a novel approach that may be esp

  4. Carrying Capacity

    DEFF Research Database (Denmark)

    Schroll, Henning; Andersen, Jan; Kjærgård, Bente

    2012-01-01

    A spatial planning act was introduced inIndonesia 1992 and renewed in 2008. It emphasised the planning role of decentralised authorities. The spatial planning act covers both spatial and environmental issues. It defines the concept of carrying capacity and includes definitions of supportive...... carrying capacity (SCC) and assimilative carrying capacity (ACC). The act mandates that the latter two aspects must be taken into consideration in the local spatial plans. The present study aimed at developing a background for a national guideline for carrying capacity in Indonesian provinces and districts...... standard or governmental political objective exists. In most cases it was possible to select a set of indicators, including thresholds that are workable in a carrying capacity planning at the local administrative levels. Not all relevant sectors at the decentralized level were included. Indicators of SCC...

  5. [Clinical and cytogenetic analysis of patients with lymphoid malignancies carrying 14q32 abnormality].

    Science.gov (United States)

    Liu, S; Qin, S; Wang, J

    2001-11-01

    To investigate the clinical and cytogenetic characteristics of patients with lymphoid malignancies (LM) harboring 14q32 abnormalities. The cases with 14q32 aberrations in 225 patients with various LM were analyzed by clinical data. Fifteen (6.67%) patients with abnormalities involving 14q32 were found and the pattern of 14q32 aberration was associated with different types of LM. t(8;14)(q24;q32) was the commonest karyotypic aberration and predominant in acute leukemias. There was no consistent profile morphologically and immunophenotypically in the involving leukemias, however there were common clinical and prognostic features and often with an additional characteristic abnormality of ins(1;6)(q11;q23q27). One case of myelodysplasia (MDS) secondary to multiple myeloma displayed t(7;14)(q34;q32) in primary clone and additional 7q- and 20q- in derivative clone that was frequently involved in MDS. 14q32 abnormalities and additional chromosomal alterations can facilitate the diagnosis and prognostic assessment for the involving LMs.

  6. A Turner Syndrome Patient Carrying a Mosaic Distal X Chromosome Marker

    Science.gov (United States)

    Mazzaschi, Roberto L. P.; Taylor, Juliet; Robertson, Stephen P.; Love, Donald R.; George, Alice M.

    2014-01-01

    A skin sample from a 17-year-old female was received for routine karyotyping with a set of clinical features including clonic seizures, cardiomyopathy, hepatic adenomas, and skeletal dysplasia. Conventional karyotyping revealed a mosaic Turner syndrome karyotype with a cell line containing a small marker of X chromosome origin. This was later confirmed on peripheral blood cultures by conventional G-banding, fluorescence in situ hybridisation and microarray analysis. Similar Turner mosaic marker chromosome cases have been previously reported in the literature, with a variable phenotype ranging from the mild “classic” Turner syndrome to anencephaly, agenesis of the corpus callosum, complex heart malformation, and syndactyly of the fingers and toes. This case report has a phenotype that is largely discordant with previously published cases as it lies at the severe end of the Turner variant phenotype scale. The observed cytogenetic abnormalities in this study may represent a coincidental finding, but we cannot exclude the possibility that the marker has a nonfunctioning X chromosome inactivation locus, leading to functional disomy of those genes carried by the marker. PMID:24778889

  7. A Turner Syndrome Patient Carrying a Mosaic Distal X Chromosome Marker

    Directory of Open Access Journals (Sweden)

    Roberto L. P. Mazzaschi

    2014-01-01

    Full Text Available A skin sample from a 17-year-old female was received for routine karyotyping with a set of clinical features including clonic seizures, cardiomyopathy, hepatic adenomas, and skeletal dysplasia. Conventional karyotyping revealed a mosaic Turner syndrome karyotype with a cell line containing a small marker of X chromosome origin. This was later confirmed on peripheral blood cultures by conventional G-banding, fluorescence in situ hybridisation and microarray analysis. Similar Turner mosaic marker chromosome cases have been previously reported in the literature, with a variable phenotype ranging from the mild “classic” Turner syndrome to anencephaly, agenesis of the corpus callosum, complex heart malformation, and syndactyly of the fingers and toes. This case report has a phenotype that is largely discordant with previously published cases as it lies at the severe end of the Turner variant phenotype scale. The observed cytogenetic abnormalities in this study may represent a coincidental finding, but we cannot exclude the possibility that the marker has a nonfunctioning X chromosome inactivation locus, leading to functional disomy of those genes carried by the marker.

  8. Effect of laparoscopic splenectomy in patients with Hepatitis C and cirrhosis carrying IL28B minor genotype

    Directory of Open Access Journals (Sweden)

    Motomura Takashi

    2012-11-01

    Full Text Available Abstract Background IL28B and ITPA genetic variants are associated with the outcome of pegylated-interferon and ribavirin (PEG-IFN/RBV therapy. However, the significance of these genetic variants in cirrhotic patients following splenectomy has not been determined. Methods Thirty-seven patients with HCV-induced cirrhosis who underwent laparoscopic splenectomy (Spx group and 90 who did not (non-Spx group were genotyped for IL28B and ITPA. The outcome or adverse effects were compared in each group. Interferon-stimulated gene 15 (ISG15 and protein kinase R expression in the spleen was measured using total RNA extracted from exenterate spleen. Results Sustained virological response (SVR rate was higher in patients carrying IL28B major genotype following splenectomy (50% vs 27.3% and in patients carrying minor genotype in the Spx group compared to non-Spx group (27.3% vs 3.6%, P 3/μl vs 168.7 × 103/μl, P Conclusions IL28B genetic variants correlated with response to PEG-IFN/RBV following splenectomy. Splenectomy improved SVR rate among patients carrying IL28B minor genotype and protected against anemia and thrombocytopenia during the course of PEG-IFN/RBV therapy regardless of ITPA genotype.

  9. Accounting for uncertainty due to 'last observation carried forward' outcome imputation in a meta-analysis model.

    Science.gov (United States)

    Dimitrakopoulou, Vasiliki; Efthimiou, Orestis; Leucht, Stefan; Salanti, Georgia

    2015-02-28

    Missing outcome data are a problem commonly observed in randomized control trials that occurs as a result of participants leaving the study before its end. Missing such important information can bias the study estimates of the relative treatment effect and consequently affect the meta-analytic results. Therefore, methods on manipulating data sets with missing participants, with regard to incorporating the missing information in the analysis so as to avoid the loss of power and minimize the bias, are of interest. We propose a meta-analytic model that accounts for possible error in the effect sizes estimated in studies with last observation carried forward (LOCF) imputed patients. Assuming a dichotomous outcome, we decompose the probability of a successful unobserved outcome taking into account the sensitivity and specificity of the LOCF imputation process for the missing participants. We fit the proposed model within a Bayesian framework, exploring different prior formulations for sensitivity and specificity. We illustrate our methods by performing a meta-analysis of five studies comparing the efficacy of amisulpride versus conventional drugs (flupenthixol and haloperidol) on patients diagnosed with schizophrenia. Our meta-analytic models yield estimates similar to meta-analysis with LOCF-imputed patients. Allowing for uncertainty in the imputation process, precision is decreased depending on the priors used for sensitivity and specificity. Results on the significance of amisulpride versus conventional drugs differ between the standard LOCF approach and our model depending on prior beliefs on the imputation process. Our method can be regarded as a useful sensitivity analysis that can be used in the presence of concerns about the LOCF process.

  10. Carrying Capacity

    DEFF Research Database (Denmark)

    Schroll, Henning; Andersen, Jan; Kjærgård, Bente

    2012-01-01

    A spatial planning act was introduced inIndonesia 1992 and renewed in 2008. It emphasised the planning role of decentralised authorities. The spatial planning act covers both spatial and environmental issues. It defines the concept of carrying capacity and includes definitions of supportive...... and ACC may increase the political focus on resources and environmental issues and may help to move local authorities towards a more holistic spatial planning approach. A carrying capacity approach could be an inspiration for local spatial planning in developing countries. A spatial planning act...... was introduced inIndonesia 1992 and renewed in 2008. It emphasised the planning role of decentralised authorities. The spatial planning act covers both spatial and environmental issues. It defines the concept of carrying capacity and includes definitions of supportive carrying capacity (SCC) and assimilative...

  11. Carrying Capacity Model Applied to Coastal Ecotourism of Baluran National Park, Indonesia

    Science.gov (United States)

    Armono, H. D.; Rosyid, D. M.; Nuzula, N. I.

    2017-07-01

    The resources of Baluran National Park have been used for marine and coastal ecotourism. The increasing number of visitors has led to the increasing of tourists and its related activities. This condition will cause the degradation of resources and the welfare of local communities. This research aims to determine the sustainability of coastal ecotourism management by calculating the effective number of tourists who can be accepted. The study uses the concept of tourism carrying capacity, consists the ecological environment, economic, social and physical carrying capacity. The results of the combined carrying capacity analysis in Baluran National Park ecotourism shows that the number of 3.288 people per day (151.248 tourists per year) is the maximum number of accepted tourists. The current number of tourist arrivals is only 241 people per day (87.990 tourists per year) which is far below the carrying capacity.

  12. Modelling of carrying capacity in National Park - Fruška Gora (Serbia case study

    Directory of Open Access Journals (Sweden)

    Vujko Aleksandra

    2017-03-01

    Full Text Available Negative effects of tourism development in a destination are usually the consequence of the high concentration of tourists, accommodation facilities and the activities that are practiced in a relatively restricted area. One of the most important measures to protect the areas is to calculate the maximum number of tourists that can simultaneously reside in a region, i.e. the determination of the carrying capacity. This paper outlines a method for determining carrying capacity based on zoning of environmental resources and zoning within a region. The paper argues for a return to the idea of identifying maximum appropriate number of users. The main hypothesis of the paper is based on the statement that the development of tourism in Fruška Gora (Mountain National Park in Northern Serbia must be in accordance with the basic principles of sustainability, including the determination of carrying capacity. The main research goal was to show the opinion of local residents about the uncontrolled development of tourism, and to determine the carrying capacity in four sports and recreational zones of the mountain. The carrying capacity of the area is calculated by Lavery and Stanev formulas.

  13. Modelling of carrying capacity in National Park - Fru\\vska Gora (Serbia) case study

    Science.gov (United States)

    Vujko, Aleksandra; Plavša, Jovan; Petrović, Marko D.; Radovanović, Milan; Gajić, Tamara

    2017-03-01

    Negative effects of tourism development in a destination are usually the consequence of the high concentration of tourists, accommodation facilities and the activities that are practiced in a relatively restricted area. One of the most important measures to protect the areas is to calculate the maximum number of tourists that can simultaneously reside in a region, i.e. the determination of the carrying capacity. This paper outlines a method for determining carrying capacity based on zoning of environmental resources and zoning within a region. The paper argues for a return to the idea of identifying maximum appropriate number of users. The main hypothesis of the paper is based on the statement that the development of tourism in Fru\\vska Gora (Mountain) National Park in Northern Serbia must be in accordance with the basic principles of sustainability, including the determination of carrying capacity. The main research goal was to show the opinion of local residents about the uncontrolled development of tourism, and to determine the carrying capacity in four sports and recreational zones of the mountain. The carrying capacity of the area is calculated by Lavery and Stanev formulas.

  14. Valproate Treatment in an ALS Patient Carrying a c.194G>A Spastin Mutation and SMN2 Homozygous Deletion

    Directory of Open Access Journals (Sweden)

    Lucio Tremolizzo

    2014-01-01

    Full Text Available Here we report the case of an ALS patient found to carry both a novel heterozygous change (c.194G>A within the spastin gene and a homozygous deletion of the SMN2 gene. The patient was started on valproic acid (VPA, 600 mg/die per os considering the capacity of this drug of increasing survival motor neuron through an epigenetic mechanism. Patient clinical course and molecular effects of VPA on skin fibroblasts obtained from the proband are described. This c.194G>A spastin mutation might expand the previously known borders of type 4 spastic paraplegia (SPG4 and we suggest the intriguing possibility that the absence of SMN2 might have acted as a contributory risk factor for starting lower motor neuron damage. Exploring the relationship genocopy-phenocopy in selected ALS patients might represent an interesting strategy for understanding its clinical variability.

  15. Evidence for clinical efficacy of mitomycin C in heavily pretreated ovarian cancer patients carrying germ-line BRCA1 mutation.

    Science.gov (United States)

    Moiseyenko, Vladimir M; Chubenko, Vyacheslav A; Moiseyenko, Fedor V; Zhabina, Albina S; Gorodnova, Tatiana V; Komarov, Yuri I; Bogdanov, Alexey A; Sokolenko, Anna P; Imyanitov, Evgeny N

    2014-10-01

    Ovarian carcinomas (OC) arising in BRCA1 and BRCA2 mutation carriers demonstrate pronounced sensitivity to platinum-based therapy due to deficiency of double-strand break DNA repair. However, the choice of subsequent treatment lines for this category of women remains complicated. We considered mitomycin C for heavily pretreated hereditary OC patients, based on multiple evidence for BRCA-specific activity of this drug. Twelve patients carrying BRCA1 germ-line mutation were included in the study. All women had a history of surgical intervention followed by adjuvant platinum-based therapy; three patients also received platinating agents prior the operation. The number of preceding treatment lines for metastatic disease was one for three patients, two for four patients, three for two patients, four for two patients and six for one woman. Administration of mitomycin C (10 mg/m2, every 4 weeks) resulted in one complete response (duration 36 weeks), two partial responses (duration 36 and 48 weeks) and six instances of disease stabilization (duration 12, 16, 20, 24, 24 and 24 weeks). In addition, three patients with the stable disease showed a decline of CA-125 level. We conclude that mitomycin C may deserve further evaluation in clinical trials involving BRCA1/2-related cancers.

  16. A simplified model predicting the weight of the load carrying beam in a wind turbine blade

    DEFF Research Database (Denmark)

    Mikkelsen, Lars Pilgaard

    2016-01-01

    to predict the weight of the load carrying beam when using glassfibre reinforced polymers, carbon fibre reinforced polymers or an aluminium alloy as the construction material. Thereby, it is found that the weight of a glass fibre wind turbine blade is increased from 0.5 to 33 tons when the blade length grows...

  17. Specifying the Role of Exposure to Violence and Violent Behavior on Initiation of Gun Carrying: A Longitudinal Test of Three Models of Youth Gun Carrying

    Science.gov (United States)

    Spano, Richard; Pridemore, William Alex; Bolland, John

    2012-01-01

    Two waves of longitudinal data from 1,049 African American youth living in extreme poverty are used to examine the impact of exposure to violence (Time 1) and violent behavior (Time 1) on first time gun carrying (Time 2). Multivariate logistic regression results indicate that (a) violent behavior (Time 1) increased the likelihood of initiation of…

  18. Specifying the Role of Exposure to Violence and Violent Behavior on Initiation of Gun Carrying: A Longitudinal Test of Three Models of Youth Gun Carrying

    Science.gov (United States)

    Spano, Richard; Pridemore, William Alex; Bolland, John

    2012-01-01

    Two waves of longitudinal data from 1,049 African American youth living in extreme poverty are used to examine the impact of exposure to violence (Time 1) and violent behavior (Time 1) on first time gun carrying (Time 2). Multivariate logistic regression results indicate that (a) violent behavior (Time 1) increased the likelihood of initiation of…

  19. Derivation of induced pluripotent stem cells from a familial Alzheimer's disease patient carrying the L282F mutation in presenilin 1

    DEFF Research Database (Denmark)

    Poon, Anna Fong-Yee; Li, Tong; Pires, Carlota

    2016-01-01

    Mutations in presenilin 1 (PSEN1) lead to the most aggressive form of familial Alzheimer's disease (AD). Human induced pluripotent stem cells (hiPSCs) derived from AD patients can be differentiated and used for disease modeling. Here, we derived hiPSC from skin fibroblasts obtained from an AD...... patient carrying a L282F mutation in PSEN1. We transfected skin fibroblasts with episomal iPSC reprogramming vectors targeting human OCT4, SOX2, L-MYC, KLF4, NANOG, LIN28, and short hairpin RNA against TP53. Our hiPSC line, L282F-hiPSC, displayed typical stem cell characteristics with consistent...

  20. Patients Carrying 9q31.1-q32 Deletion Share Common Features with Cornelia de Lange Syndrome

    Directory of Open Access Journals (Sweden)

    Ruixue Cao

    2015-01-01

    Full Text Available Background: Cornelia de Lange Syndrome (CdLS is a rare but severe clinically heterogeneous developmental disorder characterized by facial dysmorphia, growth and cognitive retardation, and abnormalities of limb development. Objectives: To determine the pathogenesis of a patient with CdLS. Methods: We studied a patient with CdLS by whole exome sequencing, karyotyping and Agilent CGH Array. The results were confirmed by quantitative real-time PCR analysis of the patient and her parents. Further comparison of our patient and cases with partially overlapping deletions retrieved from the literature and databases was undertaken. Results: Whole exome sequencing had excluded the mutation of cohesion genes such as NIPBL,SMC1A and SMC3. The result of karyotyping showed a deletion of chromosome 9q31.1-q32 and the result of Agilent CGH Array further displayed a 12.01-Mb region of deletion at chromosome bands 9q31.1-q32. Reported cases with the deletion of 9q31.1-q32 share similar features with our CdLS patient. One of the genes in the deleted region, SMC2, belongs to the Structural Maintenance of Chromosomes (SMC family and regulates gene expression and DNA repair. Conclusions: Patients carrying the deletion of 9q31.1-q32 showed similar phenotypes with CdLS.

  1. Patients carrying 9q31.1-q32 deletion share common features with Cornelia de Lange Syndrome.

    Science.gov (United States)

    Cao, Ruixue; Pu, Tian; Fang, Shaohai; Long, Fei; Xie, Jing; Xu, Yuejuan; Chen, Sun; Sun, Kun; Xu, Rang

    2015-01-01

    Cornelia de Lange Syndrome (CdLS) is a rare but severe clinically heterogeneous developmental disorder characterized by facial dysmorphia, growth and cognitive retardation, and abnormalities of limb development. To determine the pathogenesis of a patient with CdLS. We studied a patient with CdLS by whole exome sequencing, karyotyping and Agilent CGH Array. The results were confirmed by quantitative real-time PCR analysis of the patient and her parents. Further comparison of our patient and cases with partially overlapping deletions retrieved from the literature and databases was undertaken. Whole exome sequencing had excluded the mutation of cohesion genes such as NIPBL,SMC1A and SMC3. The result of karyotyping showed a deletion of chromosome 9q31.1-q32 and the result of Agilent CGH Array further displayed a 12.01-Mb region of deletion at chromosome bands 9q31.1-q32. Reported cases with the deletion of 9q31.1-q32 share similar features with our CdLS patient. One of the genes in the deleted region, SMC2, belongs to the Structural Maintenance of Chromosomes (SMC) family and regulates gene expression and DNA repair. Patients carrying the deletion of 9q31.1-q32 showed similar phenotypes with CdLS. © 2015 S. Karger AG, Basel.

  2. Proactive monitoring and adaptive management of social carrying capacity in Arches National Park: an application of computer simulation modeling.

    Science.gov (United States)

    Lawson, Steven R; Manning, Robert E; Valliere, William A; Wang, Benjamin

    2003-07-01

    Public visits to parks and protected areas continue to increase and may threaten the integrity of natural and cultural resources and the quality of the visitor experience. Scientists and managers have adopted the concept of carrying capacity to address the impacts of visitor use. In the context of outdoor recreation, the social component of carrying capacity refers to the level of visitor use that can be accommodated in parks and protected areas without diminishing the quality of the visitor experience to an unacceptable degree. This study expands and illustrates the use of computer simulation modeling as a tool for proactive monitoring and adaptive management of social carrying capacity at Arches National Park. A travel simulation model of daily visitor use throughout the Park's road and trail network and at selected attraction sites was developed, and simulations were conducted to estimate a daily social carrying capacity for Delicate Arch, an attraction site in Arches National Park, and for the Park as a whole. Further, a series of simulations were conducted to estimate the effect of a mandatory shuttle bus system on daily social carrying capacity of Delicate Arch to illustrate how computer simulation modeling can be used as a tool to facilitate adaptive management of social carrying capacity.

  3. Applying Modern Techniques and Carrying Out English .Extracurricular—— On the Model United Nations Activity

    Institute of Scientific and Technical Information of China (English)

    XuXiaoyu; WangJian

    2004-01-01

    This paper is an introduction of the extracurricular activity of the Model United Nations in Northwestern Polyteehnical University (NPU) and it focuses on the application of the modem techniques in the activity and the pedagogical theories applied in it. An interview and questionnaire research will reveal the influence of the Model United Nations.

  4. Modelling and simulation of the ice melting process on a current-carrying conductor

    Energy Technology Data Exchange (ETDEWEB)

    Peter, Z.

    2006-07-01

    Mathematical models were developed to determine the current and energy requirements for thermal de-icing and ice prevention on overhead power transmission lines. The models were based on the Joule effect under various meteorological and current transmission conditions. The minimum current intensity required to inhibit ice formation on a single power line conductor was determined. Correction factors were then introduced for 3 specific aluminum conductors with steel reinforcement (ACSRs). Water runback on the conductor surface was considered as well as deviation of the water layer from the thermal equilibrium state. Model results were in good agreement with measurements taken in an icing research wind tunnel. The overall heat transfer coefficient (HTC) for stranded conductors was then assessed to complete the model. A computational model using finite differences was also developed to calculate the current and energy requirements for de-icing partially ice covered conductors. Joule heating by AC current and impulse current were the 2 heating techniques analyzed. Thermal conductivity of the ACSR conductor was also estimated. Experimentally validated analytical approaches were proposed to determine the shedding time and corresponding energy required to de-ice a completely ice covered conductor by heating with increased nominal AC current. It was concluded that ice accretion on a single power line can be prevented using the experimentally validated mathematical models that calculate the current and energy requirements of de-icing conductors.

  5. Model for determining the load or carrying capacity of rivers and riverbanks for recreational use

    Directory of Open Access Journals (Sweden)

    Otero, I.

    2015-12-01

    Full Text Available The aim of this article is to determine the load or functional carrying capacity for the assimilation and recovery of rivers and riverbanks by compiling information on the environment, and to assess the potential for recreation from the environmental and scenic point of view. We set out to find the most significant basis for analysing the pressures limiting carrying capacity and constraining the demand for recreational use. This methodology will help planners and legislators in their decision-making. We also propose a methodology for assessing the recreational use of riverbanks, tested in a number of sites in the Madrid Region, in terms of the satisfaction the activity produces in the users, and the load or carrying capacity of the surrounding environment. A pilot site assessment is presented as a validation of the proposed methodology.El objetivo de este artículo es, determinar la capacidad de carga o acogida funcional, de asimilación y de recuperación de los márgenes y los cursos fluviales mediante la recopilación de información del medio; el potencial recreativo se evalúa además desde un doble punto de vista: ecológico y paisajístico. La forma en que se enfoca el problema y se presenta la metodología y los resultados puede resultar de gran utilidad para planificadores y legisladores. La metodología propuesta para valorar el uso recreativo de los márgenes fluviales, se aplica a una serie de parcelas en la Comunidad de Madrid, teniendo en cuenta la satisfacción que la actividad produce en los usuarios, y la capacidad de carga o acogida del entorno en el que se desarrollan. Como resultado, se presenta la valoración de parcelas piloto, que servirían para validar la metodología propuesta. [fr] Le but de cet article est, déterminer la capacité de charge ou réception fonctionnelle, l’assimilation et rétablissement des marges et les cours de la rivière par le biais de la collecte d’informations de l’environnement: le

  6. Analytical Models for Energy Consumption in Infrastructure WLAN STAs Carrying TCP Traffic

    CERN Document Server

    Agrawal, Pranav; Kuri, Joy; Panda, Manoj; Navda, Vishnu; Ramjee, Ramachandran

    2009-01-01

    We develop analytical models for estimating the energy spent by stations (STAs) in infrastructure WLANs when performing TCP controlled file downloads. We focus on the energy spent in radio communication when the STAs are in the Continuously Active Mode (CAM), or in the static Power Save Mode (PSM). Our approach is to develop accurate models for obtaining the fraction of times the STA radios spend in idling, receiving and transmitting. We discuss two traffic models for each mode of operation: (i) each STA performs one large file download, and (ii) the STAs perform short file transfers. We evaluate the rate of STA energy expenditure with long file downloads, and show that static PSM is worse than just using CAM. For short file downloads we compute the number of file downloads that can be completed with given battery capacity, and show that PSM performs better than CAM for this case. We provide a validation of our analytical models using the NS-2 simulator. In contrast to earlier work on analytical modeling of P...

  7. Biomechanical modeling and load-carrying simulation of lower limb exoskeleton.

    Science.gov (United States)

    Zhu, Yanhe; Zhang, Guoan; Zhang, Chao; Liu, Gangfeng; Zhao, Jie

    2015-01-01

    This paper introduces novel modern equipment-a lower extremity exoskeleton, which can implement the mutual complement and the interaction between human intelligence and the robot's mechanical strength. In order to provide a reference for the exoskeleton structure and the drive unit, the human biomechanics were modeled and analyzed by LifeModeler and Adams software to derive each joint kinematic parameter. The control was designed to implement the zero-force interaction between human and exoskeleton. Furthermore, simulations were performed to verify the control and assist effect. In conclusion, the system scheme of lower extremity exoskeleton is demonstrated to be feasible.

  8. Influence of local carrying capacity restrictions on stochastic predator-prey models

    Energy Technology Data Exchange (ETDEWEB)

    Washenberger, Mark J [Department of Physics and Center for Stochastic Processes in Science and Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061-0435 (United States); Mobilia, Mauro [Arnold Sommerfeld Center for Theoretical Physics and Center for NanoScience, Department of Physics, Ludwig-Maximilians-Universitaet Muenchen, D-80333 Munich (Germany); Taeuber, Uwe C [Department of Physics and Center for Stochastic Processes in Science and Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061-0435 (United States)

    2007-02-14

    We study a stochastic lattice predator-prey system by means of Monte Carlo simulations that do not impose any restrictions on the number of particles per site, and discuss the similarities and differences of our results with those obtained for site-restricted model variants. In accord with the classic Lotka-Volterra mean-field description, both species always coexist in two dimensions. Yet competing activity fronts generate complex, correlated spatio-temporal structures. As a consequence, finite systems display transient erratic population oscillations with characteristic frequencies that are renormalized by fluctuations. For large reaction rates, when the processes are rendered more local, these oscillations are suppressed. In contrast with the site-restricted predator-prey model, we also observe species coexistence in one dimension. In addition, we report results on the steady-state prey age distribution.

  9. [Measuring water ecological carrying capacity with the ecosystem-service-based ecological footprint (ESEF) method: Theory, models and application].

    Science.gov (United States)

    Jiao, Wen-jun; Min, Qing-wen; Li, Wen-hua; Fuller, Anthony M

    2015-04-01

    Integrated watershed management based on aquatic ecosystems has been increasingly acknowledged. Such a change in the philosophy of water environment management requires recognizing the carrying capacity of aquatic ecosystems for human society from a more general perspective. The concept of the water ecological carrying capacity is therefore put forward, which considers both water resources and water environment, connects socio-economic development to aquatic ecosystems and provides strong support for integrated watershed management. In this paper, the authors proposed an ESEF-based measure of water ecological carrying capacity and constructed ESEF-based models of water ecological footprint and capacity, aiming to evaluate water ecological carrying capacity with footprint methods. A regional model of Taihu Lake Basin was constructed and applied to evaluate the water ecological carrying capacity in Changzhou City which located in the upper reaches of the basin. Results showed that human demand for water ecosystem services in this city had exceeded the supply capacity of local aquatic ecosystems and the significant gap between demand and supply had jeopardized the sustainability of local aquatic ecosystems. Considering aqua-product provision, water supply and pollutant absorption in an integrated way, the scale of population and economy aquatic ecosystems in Changzhou could bear only 54% of the current status.

  10. Testing of money multiplier model for Pakistan: does monetary base carry any information?

    Directory of Open Access Journals (Sweden)

    Muhammad Arshad Khan

    2010-02-01

    Full Text Available This paper tests the constancy and stationarity of mechanic version of the money multiplier model for Pakistan using monthly data over the period 1972M1-2009M2. We split the data into pre-liberalization (1972M1-1990M12 and post-liberalization (1991M1-2009M2 periods to examine the impact of financial sector reforms. We first examine the constancy and stationarity of the money multiplier and the results suggest the money multiplier remains non-stationary for the entire sample period and sub-periods. We then tested cointegration between money supply and monetary base and find the evidence of cointegration between two variables for the entire period and two sub-periods. The coefficient restrictions are satisfied only for the post-liberalization period. Two-way long-run causality between money supply and monetary base is found for the entire period and post-liberalization. For the post-liberalization period the evidence of short-run causality running from monetary base to money supply is also identified. On the whole, the results suggest that money multiplier model can serve as framework for conducting short-run monetary policy in Pakistan. However, the monetary authority may consider the co-movements between money supply and reserve money at the time of conducting monetary policy.

  11. Structure of an Iron(II) Dioxygen Complex; A Model for Oxygen Carrying Hemeproteins

    Science.gov (United States)

    Collman, James P.; Gagne, Robert R.; Reed, Christopher A.; Robinson, Ward T.; Rodley, Gordon A.

    1974-01-01

    The preliminary structural characterization of a reversible ferrous dioxygen complex is reported. Mono(N-methyl imidazole) (dioxygen) meso-tetra (α,α,α,α-o-pivalamidephenyl) porphinatorino(II), [Fe(O2)-(N-Me imid) (α,α,α,α-TpivPP)], 1, isolated from toluene solution, crystallizes in the monoclinic system with four molecules in a unit cell of dimensions a = 18.690 (3), b = 19.514 (3), c = 18.638 (3) Å, and β = 91.00 (1)°. R = 0.15 for 841 reflections having F2 > 3σ (F2). The complex 1 has four pivalamido groups on one side of the porphyrin forming a hydrophobic pocket of 5.4-Å depth which encloses coordinated dioxygen. The dioxygen is coordinated “end-on,” with a bent Fe-O-O bond. The Fe-O-O plane bisects an N-Fe-N right angle of the equatorial iron porphyrin plane and is four way statistically disordered. In addition there is a crystallographic 2-fold axis through iron, coordinated oxygen, and nitrogen of the axially bound N-methyl imidazole. Thus there are two types of coordinated dioxygen with the Fe-O-O plane either parallel or perpendicular to the trans axial imidazole plane. Corresponding values for the Fe-O-O bond angles are 135-(4)° and 137(4)° and for the O-O bond lengths are 1.23 (0.08) and 1.26 (0.08) Å, with a dihedral angle of 90° between alternative orientations of the Fe-O-O plane. The Fe-O distance is 1.75 (0.02) Å and Fe-N (imidazole) is 2.07 (0.02) Å, suggesting multiple bond character in the Fe-O moiety. The similarity of the Mössbauer spectrum of the model complex, 1, with oxyhemoglobin indicates that 1 may be a good model for oxygen binding in the oxygen transport hemeproteins. PMID:4524640

  12. Interleukin 28B gene variation at rs12979860 determines early viral kinetics during treatment in patients carrying genotypes 2 or 3 of hepatitis C virus

    DEFF Research Database (Denmark)

    Lindh, Magnus; Lagging, Martin; Färkkilä, Martti

    2011-01-01

    Single-nucleotide polymorphisms upstream of the interleukin 28B (interferon λ3) gene (IL28B) strongly influence treatment efficacy in patients carrying hepatitis C virus (HCV) of genotype 1. In patients receiving 12 or 24 weeks of interferon-ribavirin therapy for infection with genotype 2 or 3 (n...... years (P = .01). Patients carrying CC(rs12979860) had higher baseline HCV RNA levels (P 12 weeks, achieve sustained virologic response more often than those carrying CT(rs1297986) or TT(rs1297986). The results indicate that IL28B gene testing may identify patients...

  13. Identification of Anti-tumor Cells Carrying Natural Killer (NK Cell Antigens in Patients With Hematological Cancers

    Directory of Open Access Journals (Sweden)

    Ewelina Krzywinska

    2015-10-01

    Full Text Available Natural killer (NK cells, a cytotoxic lymphocyte lineage, are able to kill tumor cells in vitro and in mouse models. However, whether these cells display an anti-tumor activity in cancer patients has not been demonstrated. Here we have addressed this issue in patients with several hematological cancers. We found a population of highly activated CD56dimCD16+ NK cells that have recently degranulated, evidence of killing activity, and it is absent in healthy donors. A high percentage of these cells expressed natural killer cell p46-related protein (NKp46, natural-killer group 2, member D (NKG2D and killer inhibitory receptors (KIRs and a low percentage expressed NKG2A and CD94. They are also characterized by a high metabolic activity and active proliferation. Notably, we found that activated NK cells from hematological cancer patients have non-NK tumor cell antigens on their surface, evidence of trogocytosis during tumor cell killing. Finally, we found that these activated NK cells are distinguished by their CD45RA+RO+ phenotype, as opposed to non-activated cells in patients or in healthy donors displaying a CD45RA+RO− phenotype similar to naïve T cells. In summary, we show that CD45RA+RO+ cells, which resemble a unique NK population, have recognized tumor cells and degranulate in patients with hematological neoplasias.

  14. Modeling and Finite Element Analysis of Load-Carrying Performance of a Wind Turbine Considering the Influence of Assembly Factors

    Directory of Open Access Journals (Sweden)

    Jianmei Wang

    2017-03-01

    Full Text Available In this work, a wind turbine shrink disk is used as the research object to investigate load-carrying performance of a multi-layer interference fit, and the theoretical model and finite element model are constructed. According to those models, a MW-level turbine shrink disk is designed, and a test device is developed to apply torque to this turbine shrink disk by hydraulic jack. Then, the circumferential slip between the contact surfaces is monitored and the slip of all contact surfaces is zero. This conclusion verifies the reasonability of the proposed models. The effect of the key influencing factors, such as machining deviation, assembly clearance and propel stroke, were analyzed. The contact pressure and load torque of the mating surfaces were obtained by building typical models with different parameters using finite element analysis (FEA. The results show that the minimum assembly clearance and the machining deviation within the machining range have little influence on load-carrying performance of multi-layer interference fit, while having a greater influence on the maximum assembly clearance and the propel stroke. The results also show that the load-carrying performance of a multiple-layer interference fit can be ensured only if the key factors are set within a reasonable design range. To avoid the abnormal operation of equipment caused by insufficient load torque, the propel stroke during practical assembly should be at least 0.95 times the designed propel stroke, which is significant in guiding the design and assembly of the multi-layer interference fit.

  15. Patient loyalty model.

    Science.gov (United States)

    Sumaedi, Sik; Bakti, I Gede Mahatma Yuda; Rakhmawati, Tri; Astrini, Nidya Judhi; Yarmen, Medi; Widianti, Tri

    2015-07-06

    This study aims to investigate the simultaneous effect of subjective norm, perceived behavioral control and trust on patient loyalty. The empirical data were collected through survey. The respondents of the survey are 157 patients of a health-care service institution in Bogor, Indonesia. Multiple regressions analysis was performed to test the conceptual model and the proposed hypotheses. The findings showed that subjective norm and trust influence patient loyalty positively. However, this research also found that perceived behavioral control does not influence patient loyalty significantly. The survey was only conducted at one health-care service institution in Bogor, Indonesia. In addition, convenience sampling method was used. These conditions may cause that the research results can not be generalized to the other contexts. Therefore, replication research is needed to test the stability of the findings in the other contexts. Health-care service institutions need to pay attention to trust and subjective norm to establish patient loyalty. This study is believed to be the first to develop and test patient loyalty model that includes subjective norm, perceived behavioral control and trust.

  16. [Ecological carrying capacity of Chinese shrimp stock enhancement in Laizhou Bay of East China based on Ecopath model].

    Science.gov (United States)

    Lin, Qun; Li, Xian-sen; Li, Zhong-yi; Jin, Xian-shi

    2013-04-01

    Stock enhancement is an important way of fishery resources conservation, which can increase the high quality fishery resources and improve the fish population structure. The study of ecological carrying capacity is the premise for the scientific implementation of stock enhancement. Based on the survey data of the fishery resources and ecological environment in Laizhou Bay from 2009 to 2010, an Ecopath mass-balance model of the Laizhou Bay ecosystem consisted of 26 functional groups was constructed, and applied to analyze the overall characteristics of the ecosystem, the trophic interrelationships, and the keystone species, and to calculate the ecological carrying capacity of Chinese shrimp enhancement. As for the overall characteristics of the ecosystem, the total primary production/total respiration (TPP/TR) was 1. 53, total primary production/total biomass (TPP/B) was 24.54, Finn' s cycling index was lower (0.07), surplus production was higher (434. 41 t km-2 a-1 ), and system connectance index was lower (0. 29), indicating that this ecosystem was at an early development stage. The analysis on the keystone species showed that Chinese shrimp was not a keystone species of this ecosystem. At present, the biomass of Chinese shrimp in the ecosystem was 0. 1143 t km-2, with a greater potential of continued enhancement. It did not exceed the ecological carrying capacity of 2. 9489 t km-2 when the biomass of the Chinese shrimp was increased by 25. 8 times.

  17. Restoration of CFTR function in patients with cystic fibrosis carrying the F508del-CFTR mutation.

    Science.gov (United States)

    De Stefano, Daniela; Villella, Valeria R; Esposito, Speranza; Tosco, Antonella; Sepe, Angela; De Gregorio, Fabiola; Salvadori, Laura; Grassia, Rosa; Leone, Carlo A; De Rosa, Giuseppe; Maiuri, Maria C; Pettoello-Mantovani, Massimo; Guido, Stefano; Bossi, Anna; Zolin, Anna; Venerando, Andrea; Pinna, Lorenzo A; Mehta, Anil; Bona, Gianni; Kroemer, Guido; Maiuri, Luigi; Raia, Valeria

    2014-01-01

    Restoration of BECN1/Beclin 1-dependent autophagy and depletion of SQSTM1/p62 by genetic manipulation or autophagy-stimulatory proteostasis regulators, such as cystamine, have positive effects on mouse models of human cystic fibrosis (CF). These measures rescue the functional expression of the most frequent pathogenic CFTR mutant, F508del, at the respiratory epithelial surface and reduce lung inflammation in Cftr(F508del) homozygous mice. Cysteamine, the reduced form of cystamine, is an FDA-approved drug. Here, we report that oral treatment with cysteamine greatly reduces the mortality rate and improves the phenotype of newborn mice bearing the F508del-CFTR mutation. Cysteamine was also able to increase the plasma membrane expression of the F508del-CFTR protein in nasal epithelial cells from F508del homozygous CF patients, and these effects persisted for 24 h after cysteamine withdrawal. Importantly, this cysteamine effect after washout was further sustained by the sequential administration of epigallocatechin gallate (EGCG), a green tea flavonoid, both in vivo, in mice, and in vitro, in primary epithelial cells from CF patients. In a pilot clinical trial involving 10 F508del-CFTR homozygous CF patients, the combination of cysteamine and EGCG restored BECN1, reduced SQSTM1 levels and improved CFTR function from nasal epithelial cells in vivo, correlating with a decrease of chloride concentrations in sweat, as well as with a reduction of the abundance of TNF/TNF-alpha (tumor necrosis factor) and CXCL8 (chemokine [C-X-C motif] ligand 8) transcripts in nasal brushing and TNF and CXCL8 protein levels in the sputum. Altogether, these results suggest that optimal schedules of cysteamine plus EGCG might be used for the treatment of CF caused by the F508del-CFTR mutation.

  18. Generation of a gene-corrected isogenic control cell line from an Alzheimer's disease patient iPSC line carrying a A79V mutation in PSEN1

    Directory of Open Access Journals (Sweden)

    Carlota Pires

    2016-09-01

    Full Text Available Alzheimer's disease (AD is a progressive and irreversible neurodegenerative disease causing neural cell degeneration and brain atrophy and is considered to be the most common form of dementia. We previously generated an induced pluripotent stem cell (iPSC line from an AD patient carrying an A79V mutation in PSEN1 as an in vitro disease model. Here we generated a gene-corrected version from this hiPSC line by substituting the point mutation with the wild-type sequence. The reported A79V-GC-iPSCs line is a very useful resource in combination with the A79V-iPSC line in order to study pathological cellular phenotypes related to this particular mutation.

  19. Generation of a gene-corrected isogenic control cell line from an Alzheimer's disease patient iPSC line carrying a A79V mutation in PSEN1

    DEFF Research Database (Denmark)

    Pires, Carlota; Schmid, Benjamin; Petræus, Carina

    2016-01-01

    Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disease causing neural cell degeneration and brain atrophy and is considered to be the most common form of dementia. We previously generated an induced pluripotent stem cell (iPSC) line from an AD patient carrying an A79V...... mutation in PSEN1 as an in vitro disease model. Here we generated a gene-corrected version from this hiPSC line by substituting the point mutation with the wild-type sequence. The reported A79V-GC-iPSCs line is a very useful resource in combination with the A79V-iPSC line in order to study pathological...

  20. Carrying the physics of black-hole binary evolution into gravitational-wave models for pulsar-timing arrays

    Science.gov (United States)

    Taylor, Stephen; Sampson, Laura; Simon, Joseph

    2016-03-01

    There has recently been significant interest in how the galactic environments of supermassive black-hole binaries influences the stochastic gravitational-wave background signal from a population of these systems, and in how the resulting detection prospects for pulsar-timing arrays are effected. Tackling these problems requires us to have robust and computationally-efficient models for the strain spectrum as a function of different environment influences or the binary orbital eccentricity. In this talk we describe a new method of constructing these models from a small number of synthesized black-hole binary populations which have varying input physics. We use these populations to train an interpolant via Gaussian-process regression, allowing us to carry real physics into our subsequent pulsar-timing array inferences, and to also correctly propagate forward uncertainties from our interpolation.

  1. Induced pluripotent stem cell generation from a man carrying a complex chromosomal rearrangement as a genetic model for infertility studies

    Science.gov (United States)

    Mouka, Aurélie; Izard, Vincent; Tachdjian, Gérard; Brisset, Sophie; Yates, Frank; Mayeur, Anne; Drévillon, Loïc; Jarray, Rafika; Leboulch, Philippe; Maouche-Chrétien, Leila; Tosca, Lucie

    2017-01-01

    Despite progress in human reproductive biology, the cause of male infertility often remains unknown, due to the lack of appropriate and convenient in vitro models of meiosis. Induced pluripotent stem cells (iPSCs) derived from the cells of infertile patients could provide a gold standard model for generating primordial germ cells and studying their development and the process of spermatogenesis. We report the characterization of a complex chromosomal rearrangement (CCR) in an azoospermic patient, and the successful generation of specific-iPSCs from PBMC-derived erythroblasts. The CCR was characterized by karyotype, fluorescence in situ hybridization and oligonucleotide-based array-comparative genomic hybridization. The CCR included five breakpoints and was caused by the inverted insertion of a chromosome 12 segment into the short arm of one chromosome 7 and a pericentric inversion of the structurally rearranged chromosome 12. Gene mapping of the breakpoints led to the identification of a candidate gene, SYCP3. Erythroblasts from the patient were reprogrammed with Sendai virus vectors to generate iPSCs. We assessed iPSC pluripotency by RT-PCR, immunofluorescence staining and teratoma induction. The generation of specific-iPSCs from patients with a CCR provides a valuable in vitro genetic model for studying the mechanisms by which chromosomal abnormalities alter meiosis and germ cell development. PMID:28045072

  2. Induced pluripotent stem cell generation from a man carrying a complex chromosomal rearrangement as a genetic model for infertility studies.

    Science.gov (United States)

    Mouka, Aurélie; Izard, Vincent; Tachdjian, Gérard; Brisset, Sophie; Yates, Frank; Mayeur, Anne; Drévillon, Loïc; Jarray, Rafika; Leboulch, Philippe; Maouche-Chrétien, Leila; Tosca, Lucie

    2017-01-03

    Despite progress in human reproductive biology, the cause of male infertility often remains unknown, due to the lack of appropriate and convenient in vitro models of meiosis. Induced pluripotent stem cells (iPSCs) derived from the cells of infertile patients could provide a gold standard model for generating primordial germ cells and studying their development and the process of spermatogenesis. We report the characterization of a complex chromosomal rearrangement (CCR) in an azoospermic patient, and the successful generation of specific-iPSCs from PBMC-derived erythroblasts. The CCR was characterized by karyotype, fluorescence in situ hybridization and oligonucleotide-based array-comparative genomic hybridization. The CCR included five breakpoints and was caused by the inverted insertion of a chromosome 12 segment into the short arm of one chromosome 7 and a pericentric inversion of the structurally rearranged chromosome 12. Gene mapping of the breakpoints led to the identification of a candidate gene, SYCP3. Erythroblasts from the patient were reprogrammed with Sendai virus vectors to generate iPSCs. We assessed iPSC pluripotency by RT-PCR, immunofluorescence staining and teratoma induction. The generation of specific-iPSCs from patients with a CCR provides a valuable in vitro genetic model for studying the mechanisms by which chromosomal abnormalities alter meiosis and germ cell development.

  3. The 'carry-over' effects of patient self-testing: positive effects on usual care management by an anticoagulation management service.

    LENUS (Irish Health Repository)

    Ryan, Fiona

    2010-11-01

    Patient self-testing (PST) of the international normalised ratio (INR) has a positive effect on anticoagulation control. This study investigated whether the benefits of PST (other than increased frequency of testing, e.g. patient education, empowerment, compliance etc.) could be \\'carried-over\\' into usual care management after a period of home-testing has ceased.

  4. Derivation, Characterization, and Neural Differentiation of Integration-Free Induced Pluripotent Stem Cell Lines from Parkinson's Disease Patients Carrying SNCA, LRRK2, PARK2, and GBA Mutations.

    Science.gov (United States)

    Momcilovic, Olga; Sivapatham, Renuka; Oron, Tal Ronnen; Meyer, Morten; Mooney, Sean; Rao, Mahendra S; Zeng, Xianmin

    2016-01-01

    We report generation of induced pluripotent stem cell (iPSC) lines from ten Parkinson's disease (PD) patients carrying SNCA, PARK2, LRRK2, and GBA mutations, and one age-matched control. After validation of pluripotency, long-term genome stability, and integration-free reprogramming, eight of these lines (one of each SNCA, LRRK2 and GBA, four PARK2 lines, and the control) were differentiated into neural stem cells (NSC) and subsequently to dopaminergic cultures. We did not observe significant differences in the timeline of neural induction and NSC derivation between the patient and control line, nor amongst the patient lines, although we report considerable variability in the efficiency of dopaminergic differentiation among patient lines. We performed whole genome expression analyses of the lines at each stage of differentiation (fibroblast, iPSC, NSC, and dopaminergic culture) in an attempt to identify alterations by large-scale evaluation. While gene expression profiling clearly distinguished cells at different stages of differentiation, no mutation-specific clustering or difference was observed, though consistent changes in patient lines were detected in genes associated mitochondrial biology. We further examined gene expression in a stress model (MPTP-induced dopaminergic neuronal death) using two clones from the SNCA triplication line, and detected changes in genes associated with mitophagy. Our data suggested that even a well-characterized line of a monogenic disease may not be sufficient to determine the cause or mechanism of the disease, and highlights the need to use more focused strategies for large-scale data analysis.

  5. Modelling of the UO{sub 2} dissolution mechanisms in synthetic groundwater. Experiments carried out under anaerobic and reducing conditions

    Energy Technology Data Exchange (ETDEWEB)

    Cera, E.; Grive, M.; Bruno, J. [EnvirosQuantiSci (Spain); Ollila, K. [VTT Chemical Technology, Espoo (Finland)

    2000-07-01

    The experimental data generated under anaerobic and reducing conditions within the EU R and D programme 1996-1998 entitled 'Source term for performance assessment of spent fuel as a waste form' and published as a POSIVA report (Ollila, 1999) have been modelled in the present work. The dissolution data available, mainly U in the aqueous phase as a function of time and redox potentials have been used to elucidate the redox pairs controlling the redox potential of the systems studied. Dissolution experiments carried out under anaerobic conditions have shown the important role of the uranium system on buffering the redox capacity of these systems. In the presence of carbonates in the system, the redox control has been given by the UO{sub 2}(c)/U(VI) aqueous redox couple while in absence of carbonates in the system, the redox control has been governed by the UO{sub 2}(c)/UO{sub 2+x} transition. In addition dissolution rates have been satisfactorily modelled by assuming an oxidative dissolution mechanism consisting in an initial oxidation of the surface of the uranium dioxide, binding of the HCO{sub 3} or H+ at the U(VI) sites of the oxidised surface layer and detachment of these surface complexes. The redox controls in the experiments carried out under reducing conditions have been exerted by the different reducing agents added in the systems. Therefore, the addition of Fe{sup 2+} lead to a redox control exerted by the Fe{sup 2+}/Fe(OH){sub 3}(s) redox pair, while the addition of sulphide lead to a different redox control governed by the HS/SO{sub 3}{sup 2-} redox pair. (orig.)

  6. Generation of a gene-corrected isogenic control hiPSC line derived from a familial Alzheimer's disease patient carrying a L150P mutation in presenilin 1

    DEFF Research Database (Denmark)

    Poon, Anna Fong-Yee; Schmid, Benjamin; Pires, Carlota

    2016-01-01

    a familial AD patient carrying a L150P point mutation in PSEN1. Here we used CRISPR/Cas9 gene editing to correct for the single base pair mutation. This gene-corrected line, L150P-GC-hiPSC, serves as an isogenic control to the mutant line for future investigation of mechanisms and cellular phenotypes altered...

  7. Generation of a gene-corrected isogenic control cell line from an Alzheimer's disease patient iPSC line carrying a A79V mutation in PSEN1

    DEFF Research Database (Denmark)

    Pires, Carlota; Schmid, Benjamin; Petræus, Carina;

    2016-01-01

    Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disease causing neural cell degeneration and brain atrophy and is considered to be the most common form of dementia. We previously generated an induced pluripotent stem cell (iPSC) line from an AD patient carrying an A79V...

  8. Refinement of genotype-phenotype correlation in 18 patients carrying a 1q24q25 deletion

    DEFF Research Database (Denmark)

    Chatron, Nicolas; Haddad, Véronique; Andrieux, Joris

    2015-01-01

    Interstitial deletion 1q24q25 is a rare rearrangement associated with intellectual disability, growth retardation, abnormal extremities and facial dysmorphism. In this study, we describe the largest series reported to date, including 18 patients (4M/14F) aged from 2 days to 67 years and comprising...

  9. Clinical and molecular characterization of Rubinstein-Taybi syndrome patients carrying distinct novel mutations of the EP300 gene.

    Science.gov (United States)

    Negri, G; Milani, D; Colapietro, P; Forzano, F; Della Monica, M; Rusconi, D; Consonni, L; Caffi, L G; Finelli, P; Scarano, G; Magnani, C; Selicorni, A; Spena, S; Larizza, L; Gervasini, C

    2015-02-01

    Rubinstein-Taybi syndrome (RSTS) is a rare congenital neurodevelopmental disorder characterized by postnatal growth deficiency, skeletal abnormalities, dysmorphic features and cognitive deficit. Mutations in two genes, CREBBP and EP300, encoding two homologous transcriptional co-activators, have been identified in ˜55% and ˜3-5% of affected individuals, respectively. To date, only eight EP300-mutated RSTS patients have been described and 12 additional mutations are reported in the database LOVD. In this study, EP300 analysis was performed on 33 CREBBP-negative RSTS patients leading to the identification of six unreported germline EP300 alterations comprising one deletion and five point mutations. All six patients showed a convincing, albeit mild, RSTS phenotype with minor skeletal anomalies, slight cognitive impairment and few major malformations. Beyond the expansion of the RSTS-EP300-mutated cohort, this study indicates that EP300-related RSTS cases occur more frequently than previously thought (˜8% vs 3-5%); furthermore, the characterization of novel EP300 mutations in RSTS patients will enhance the clinical practice and genotype-phenotype correlations.

  10. Indium-111 labelled platelet scintigraphy can predict the immunological origin of fever in patients on dialysis carrying a non-functioning renal allograft

    Energy Technology Data Exchange (ETDEWEB)

    Fuster, D.; Lomena, F.; Piera, C.; Setoain, F.J.; Laterza, C.; Herranz, R.; Setoain, J. [Nuclear Medicine Dept., Hospital Clinic de Barcelona (Spain); Torregrosa, J.V.; Oppenheimer, F. [Renal Transplant Unit, Hospital Clinic de Barcelona (Spain)

    2000-03-01

    The purpose of this study was to evaluate the usefulness of labelled platelet scintigraphy in the differential diagnosis of a prolonged febrile syndrome (PFS) in patients on dialysis carrying a non-functioning renal allograft. We prospectively performed an indium-111 mercaptopyridine-labelled platelet scan on 91 patients (54 men, 37 women; mean age 39.6{+-}12 years). The mean duration of PFS was 35 days (range 7-122). Forty-six of the 91 patients underwent steroid therapy (2- 10 mg/day). Platelet labelling was carried out following Thakur's method. Platelet scans were performed 48 h after reinjection of labelled platelets. The platelet uptake index (PUI) was calculated by dividing the cpm/pixel in the allograft ROI by cpm/pixel in a mirror background ROI. The final diagnosis of PFS was established depending on the outcome after treatment. In 61/91 patients the fever had an immunological origin because it disappeared after graft embolisation or transplantectomy. In 30/91 patients the PFS disappeared after antibiotic therapy (non-immunological origin). The PUI in patients with immunological PFS was 1.80{+-}0.7, while in patients with non-immunological PFS it was 1.12{+-}0.1 (P<0.05). When a PUI of {>=}1.5 was considered as the threshold to establish PFS of immunological origin, the sensitivity of platelet scan was 76%, the specificity 100%, and the negative and positive predictive values 69% and 100%, respectively. In patients classified with immunological PFS who underwent steroid therapy, the PUI was significantly lower than in patients without steroids (P<0.05). These results suggest that {sup 111}In-labelled platelet scintigraphy can accurately predict an immunological PFS in patients on dialysis carrying a non-functioning renal allograft. Therapy with steroids could reduce the sensitivity of {sup 111}In-labelled platelet scintigraphy in detecting immunological PFS. (orig.)

  11. Emerging Carbapenem-Resistant Pseudomonas aeruginosa Isolates Carrying blaIMP Among Burn Patients in Isfahan, Iran

    Science.gov (United States)

    Radan, Mohsen; Moniri, Rezvan; Khorshidi, Ahmad; Gilasi, Hamidreza; Norouzi, Zohreh; Beigi, Fahimeh; Dasteh Goli, Yasaman

    2016-01-01

    Background Metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa is a significant pathogen in burn patients. Objectives The aim of this study was to determine the prevalence of carbapenem-resistant P. aeruginosa isolates, including those resistant to imipenemase (IMP), in a burn unit in Isfahan, Iran. Patients and Methods One hundred and fifty P. aeruginosa isolates from burn patients were tested for antibiotic susceptibility by the disc diffusion method in accordance with CLSI guidelines. Production of MBL was identified with the EDTA disk method. DNA was purified from the MBL-positive isolates, and detection of the blaIMP gene was performed with PCR. Results Fifty-seven out of 150 (38%) isolates were multi-drug resistant (MDR), and 93 (62%) were extensively-drug resistant (XDR). Among all isolates, the resistance rate to ciprofloxacin, tobramycin, imipenem, meropenem, amikacin, ceftazidime, and cefepime was higher than 90%, while the resistance rates to piperacillin/tazobactam and aztreonam were 70.7% and 86%, respectively. Colistin and polymyxin B remained the most effective studied antibiotics. All of the imipenem-resistant P. aeruginosa isolates were MBL-positive, and 107 out of 144 (74.3%) of the MBL isolates were positive for the blaIMP gene. Conclusions The results of this study show that the rate of P. aeruginosa-caused burn wound infections was very high, and many of the isolates were resistant to three or more classes of antimicrobials. Such extensive resistance to antimicrobial classes is important because few treatment options remain for patients with burn wound infections. blaIMP-producing P. aeruginosa isolates are a rising threat in burn-care units, and should be controlled by conducting infection-control assessments.

  12. Rapid Progression of Sporadic ALS in a Patient Carrying SOD1 p.Gly13Arg Mutation

    Science.gov (United States)

    Kim, Myung-Jin; Bae, Jae-Han; Kim, Jeong-Min; Kim, Hye Ryoun; Yoon, Byung-Nam; Sung, Jung-Joon

    2016-01-01

    Amyotrophic lateral sclerosis (ALS), the most common adult onset motor neuron disease, is pathologically characterized by progressive loss of the upper and lower motor neurons. Mutations in the Cu/Zn superoxide dismutase gene (SOD1) account for about 20% of familial ALS cases and a small percentage of sporadic ALS (SALS) cases, and have revealed a validated genotype-phenotype correlation. Herein, we report a p.Gly13Arg mutation in SOD1 exon 1 in a patient with SALS who presented with a rapidly progressive course, predominantly affecting the lower motor neurons. A 48-year-old man presented with progressive weakness and muscle atrophy of the left upper and lower limbs, followed by muscle fasciculation and cramping. The clinical features of the patient were clearly suggestive of ALS, and implied a sporadic form with rapid progression, predominantly affecting the lower motor neurons. Sequencing of the SOD1 gene by PCR revealed a missense mutation of G to C (c.37G>C) in exon 1, and amino acid substitution of glycine by arginine (p.Gly13Arg). This is the first case identifying the p.Gly13Arg mutation of SOD1 in the Korean population, and clinical assessments of this patient revealed a different phenotype compared with other cases. PMID:28035186

  13. Early Complete Molecular Response to First-Line Nilotinib in Two Patients with Chronic Myeloid Leukemia Carrying the p230 Transcript

    Directory of Open Access Journals (Sweden)

    Marianna Greco

    2013-01-01

    Full Text Available Chronic myeloid leukemia (CML with the rare fusion gene e19a2, encoding a p230 protein, has been described in patients with typical or rather aggressive clinical course. Although tyrosine kinase inhibitors (TKIs induce a substantial cytogenetic and molecular response in all phases of CML, a minority of p230 positive patients have been treated with TKIs. We report two cases of CML patients carrying the p230 transcript, who achieved fast and deep complete molecular response (CMR after frontline treatment with nilotinib. Our results suggest the use of nilotinib as frontline agent for the treatment of this CML variant.

  14. Effective carrying capacity and analytical solution of a particular case of the Richards-like two-species population dynamics model

    Science.gov (United States)

    Cabella, Brenno Caetano Troca; Ribeiro, Fabiano; Martinez, Alexandre Souto

    2012-02-01

    We consider a generalized two-species population dynamic model and analytically solve it for the amensalism and commensalism ecological interactions. These two-species models can be simplified to a one-species model with a time dependent extrinsic growth factor. With a one-species model with an effective carrying capacity one is able to retrieve the steady state solutions of the previous one-species model. The equivalence obtained between the effective carrying capacity and the extrinsic growth factor is complete only for a particular case, the Gompertz model. Here we unveil important aspects of sigmoid growth curves, which are relevant to growth processes and population dynamics.

  15. Skeletal muscle microalterations in patients carrying Malignant Hyperthermia-related mutations of the e-c coupling machinery

    Directory of Open Access Journals (Sweden)

    Manuela Lavorato

    2016-09-01

    Full Text Available We have compared the ultrastructure of skeletal muscle biopsies from patients that have survived a [Malignant Hyperthermia, MH] episode and siblings that test positive for MH susceptibility with those from siblings that tested negatives. The aim is to establish whether life long exposure to the MH-related mutation effects may result in subtle abnormalities even in the absence of active episodes and/or clinically detectable deficiencies. Although a specific ultrastructural signature for MH mutants cannot be demonstrated, an MH related pattern of minor alterations does exist. These include the tendency for micro damage to the contractile apparatus and a higher than normal level of mitochondrial abnormalities.

  16. Restoration of CFTR function in patients with cystic fibrosis carrying the F508del-CFTR mutation

    OpenAIRE

    De Stefano, Daniela; Villella, Valeria R.; Esposito, Speranza; Tosco, Antonella; Sepe, Angela; Gregorio, Fabiola De; Salvadori, Laura; Grassia, Rosa; Leone, Carlo A; Rosa, Giuseppe De; Maria C Maiuri; Pettoello-Mantovani, Massimo; Guido, Stefano; Bossi, Anna; Zolin, Anna

    2014-01-01

    Restoration of BECN1/Beclin 1-dependent autophagy and depletion of SQSTM1/p62 by genetic manipulation or autophagy-stimulatory proteostasis regulators, such as cystamine, have positive effects on mouse models of human cystic fibrosis (CF). These measures rescue the functional expression of the most frequent pathogenic CFTR mutant, F508del, at the respiratory epithelial surface and reduce lung inflammation in CftrF508del homozygous mice. Cysteamine, the reduced form of cystamine, is an FDA-app...

  17. Impact of the CFTR-potentiator ivacaftor on airway microbiota in cystic fibrosis patients carrying a G551D mutation.

    Directory of Open Access Journals (Sweden)

    Cédric Bernarde

    Full Text Available Airway microbiota composition has been clearly correlated with many pulmonary diseases, and notably with cystic fibrosis (CF, an autosomal genetic disorder caused by mutation in the CF transmembrane conductance regulator (CFTR. Recently, a new molecule, ivacaftor, has been shown to re-establish the functionality of the G551D-mutated CFTR, allowing significant improvement in lung function.The purpose of this study was to follow the evolution of the airway microbiota in CF patients treated with ivacaftor, using quantitative PCR and pyrosequencing of 16S rRNA amplicons, in order to identify quantitative and qualitative changes in bacterial communities. Three G551D children were followed up longitudinally over a mean period of more than one year covering several months before and after initiation of ivacaftor treatment.129 operational taxonomy units (OTUs, representing 64 genera, were identified. There was no significant difference in total bacterial load before and after treatment. Comparison of global community composition found no significant changes in microbiota. Two OTUs, however, showed contrasting dynamics: after initiation of ivacaftor, the relative abundance of the anaerobe Porphyromonas 1 increased (p<0.01 and that of Streptococcus 1 (S. mitis group decreased (p<0.05, possibly in relation to the anti-Gram-positive properties of ivacaftor. The anaerobe Prevotella 2 correlated positively with the pulmonary function test FEV-1 (r=0.73, p<0.05. The study confirmed the presumed positive role of anaerobes in lung function.Several airway microbiota components, notably anaerobes (obligate or facultative anaerobes, could be valuable biomarkers of lung function improvement under ivacaftor, and could shed light on the pathophysiology of lung disease in CF patients.

  18. Clinical and functional characterization of a patient carrying a compound heterozygous pericentrin mutation and a heterozygous IGF1 receptor mutation.

    Science.gov (United States)

    Müller, Eva; Dunstheimer, Desiree; Klammt, Jürgen; Friebe, Daniela; Kiess, Wieland; Kratzsch, Jürgen; Kruis, Tassilo; Laue, Sandy; Pfäffle, Roland; Wallborn, Tillmann; Heidemann, Peter H

    2012-01-01

    Intrauterine and postnatal longitudinal growth is controlled by a strong genetic component that regulates a complex network of endocrine factors integrating them with cellular proliferation, differentiation and apoptotic processes in target tissues, particularly the growth centers of the long bones. Here we report on a patient born small for gestational age (SGA) with severe, proportionate postnatal growth retardation, discreet signs of skeletal dysplasia, microcephaly and moyamoya disease. Initial genetic evaluation revealed a novel heterozygous IGF1R p.Leu1361Arg mutation affecting a highly conserved residue with the insulin-like growth factor type 1 receptor suggestive for a disturbance within the somatotropic axis. However, because the mutation did not co-segregate with the phenotype and functional characterization did not reveal an obvious impairment of the ligand depending major IGF1R signaling capabilities a second-site mutation was assumed. Mutational screening of components of the somatotropic axis, constituents of the IGF signaling system and factors involved in cellular proliferation, which are described or suggested to provoke syndromic dwarfism phenotypes, was performed. Two compound heterozygous PCNT mutations (p.[Arg585X];[Glu1774X]) were identified leading to the specification of the diagnosis to MOPD II. These investigations underline the need for careful assessment of all available information to derive a firm diagnosis from a sequence aberration.

  19. Clinical and functional characterization of a patient carrying a compound heterozygous pericentrin mutation and a heterozygous IGF1 receptor mutation.

    Directory of Open Access Journals (Sweden)

    Eva Müller

    Full Text Available Intrauterine and postnatal longitudinal growth is controlled by a strong genetic component that regulates a complex network of endocrine factors integrating them with cellular proliferation, differentiation and apoptotic processes in target tissues, particularly the growth centers of the long bones. Here we report on a patient born small for gestational age (SGA with severe, proportionate postnatal growth retardation, discreet signs of skeletal dysplasia, microcephaly and moyamoya disease. Initial genetic evaluation revealed a novel heterozygous IGF1R p.Leu1361Arg mutation affecting a highly conserved residue with the insulin-like growth factor type 1 receptor suggestive for a disturbance within the somatotropic axis. However, because the mutation did not co-segregate with the phenotype and functional characterization did not reveal an obvious impairment of the ligand depending major IGF1R signaling capabilities a second-site mutation was assumed. Mutational screening of components of the somatotropic axis, constituents of the IGF signaling system and factors involved in cellular proliferation, which are described or suggested to provoke syndromic dwarfism phenotypes, was performed. Two compound heterozygous PCNT mutations (p.[Arg585X];[Glu1774X] were identified leading to the specification of the diagnosis to MOPD II. These investigations underline the need for careful assessment of all available information to derive a firm diagnosis from a sequence aberration.

  20. Breakpoint mapping by next generation sequencing reveals causative gene disruption in patients carrying apparently balanced chromosome rearrangements with intellectual deficiency and/or congenital malformations.

    Science.gov (United States)

    Schluth-Bolard, Caroline; Labalme, Audrey; Cordier, Marie-Pierre; Till, Marianne; Nadeau, Gwenaël; Tevissen, Hélène; Lesca, Gaétan; Boutry-Kryza, Nadia; Rossignol, Sylvie; Rocas, Delphine; Dubruc, Estelle; Edery, Patrick; Sanlaville, Damien

    2013-03-01

    Apparently balanced chromosomal rearrangements (ABCR) are associated with an abnormal phenotype in 6% of cases. This may be due to cryptic genomic imbalances or to the disruption of genes at the breakpoint. However, breakpoint cloning using conventional methods (ie, fluorescent in situ hybridisation (FISH), Southern blot) is often laborious and time consuming. In this work, we used next generation sequencing (NGS) to locate breakpoints at the molecular level in four patients with multiple congenital abnormalities and/or intellectual deficiency (MCA/ID) who were carrying ABCR (one translocation, one complex chromosomal rearrangement and two inversions), which corresponded to nine breakpoints. Genomic imbalance was previously excluded by array comparative genomic hybridisation (CGH) in all four patients. Whole genome paired-end protocol was used to identify breakpoints. The results were verified by FISH and by PCR with Sanger sequencing. We were able to map all nine breakpoints. NGS revealed an additional breakpoint due to a cryptic inversion at a breakpoint junction in one patient. Nine of 10 breakpoints occurred in repetitive elements and five genes were disrupted in their intronic sequence (TCF4, SHANK2, PPFIA1, RAB19, KCNQ1). NGS is a powerful tool allowing rapid breakpoint cloning of ABCR at the molecular level. We showed that in three out of four patients, gene disruption could account for the phenotype, allowing adapted genetic counselling and stopping unnecessary investigations. We propose that patients carrying ABCR with an abnormal phenotype should be explored systematically by NGS once a genomic imbalance has been excluded by array CGH.

  1. A simple steady-state model for carry-over of aflatoxins from feed to cow's milk.

    NARCIS (Netherlands)

    Eijkeren, Jan C H van; Bakker, Martine I; Zeilmaker, Marco J

    2006-01-01

    A simple steady-state model is derived from two kinetic one-compartment models for the disposition of aflatoxin B1 (AFB1) and aflatoxin M1 (AFM1) in the lactating cow. The model relates daily intake of AFB1 in feed of dairy cattle and the cow's lactation status to resulting concentrations of AFM1 in

  2. Derivation, Characterization, and Neural Differentiation of Integration-Free Induced Pluripotent Stem Cell Lines from Parkinson's Disease Patients Carrying SNCA, LRRK2, PARK2, and GBA Mutations

    DEFF Research Database (Denmark)

    Momcilovic, Olga; Sivapatham, Renuka; Oron, Tal Ronnen

    2016-01-01

    We report generation of induced pluripotent stem cell (iPSC) lines from ten Parkinson's disease (PD) patients carrying SNCA, PARK2, LRRK2, and GBA mutations, and one age-matched control. After validation of pluripotency, long-term genome stability, and integration-free reprogramming, eight...... of these lines (one of each SNCA, LRRK2 and GBA, four PARK2 lines, and the control) were differentiated into neural stem cells (NSC) and subsequently to dopaminergic cultures. We did not observe significant differences in the timeline of neural induction and NSC derivation between the patient and control line...... to identify alterations by large-scale evaluation. While gene expression profiling clearly distinguished cells at different stages of differentiation, no mutation-specific clustering or difference was observed, though consistent changes in patient lines were detected in genes associated mitochondrial biology...

  3. Generation of induced pluripotent stem cells (iPSCs from a retinoblastoma patient carrying a c.2663G>A mutation in RB1 gene

    Directory of Open Access Journals (Sweden)

    Sicong Zeng

    2016-09-01

    Full Text Available Skin fibroblasts were obtained from a male patient diagnosed with retinoblastoma (RB carrying a c.2663G>A mutation in the 25 exon of RB1 gene. RB-iPS cells was generated via delivered four reprogramming factors (OCT4, SOX2, NANOG and LIN28 into these skin fibroblasts. The RB-iPS cells retained the RB1 heterozygous mutation resulted in a truncated RB1 mRNA. Characteristic tests proved that the iPSC line presented typical markers of pluripotency and had the capability to form the three germ layers in vitro.

  4. Patient-Specific Computational Modeling

    CERN Document Server

    Peña, Estefanía

    2012-01-01

    This book addresses patient-specific modeling. It integrates computational modeling, experimental procedures, imagine clinical segmentation and mesh generation with the finite element method (FEM) to solve problems in computational biomedicine and bioengineering. Specific areas of interest include cardiovascular problems, ocular and muscular systems and soft tissue modeling. Patient-specific modeling has been the subject of serious research over the last seven years and interest in the area is continually growing and this area is expected to further develop in the near future.

  5. Novel treatment for lithium-induced nephrogenic diabetes insipidus rat model using the Sendai-virus vector carrying aquaporin 2 gene.

    Science.gov (United States)

    Suga, Hidetaka; Nagasaki, Hiroshi; Kondo, Taka-Aki; Okajima, Yoshiki; Suzuki, Chizuko; Ozaki, Nobuaki; Arima, Hiroshi; Yamamoto, Tokunori; Ozaki, Noriyuki; Akai, Masaro; Sato, Aiko; Uozumi, Nobuyuki; Inoue, Makoto; Hasegawa, Mamoru; Oiso, Yutaka

    2008-11-01

    Congenital nephrogenic diabetes insipidus (NDI) is a chronic disorder involving polyuria and polydipsia that results from unresponsiveness of the renal collecting ducts to the antidiuretic hormone vasopressin. Either of the genetic defects in vasopressin V2 receptor or the water channel aquaporin 2 (AQP2) cause the disease, which interfere the water reabsorption at the epithelium of the collecting duct. An unconscious state including a perioperative situation can be life threatening because of the difficulty to regulate their water balance. The Sendai virus (SeV) vector system deleting fusion protein (F) gene (SeV/DeltaF) is considered most suitable because of the short replication cycle and nontransmissible character. An animal model for NDI with reduced AQP2 by lithium chloride was used to develop the therapy. When the SeV/DeltaF vector carrying a human AQP2 gene (AQP2-SeV/DeltaF) was administered retrogradely via ureter to renal pelvis, AQP2 was expressed in the renal collecting duct to reduce urine output and water intake by up to 40%. In combination with the retorograde administration to pelvis, this system could be the cornerstone for the applicable therapies on not only NDI patients but also other diseases associate with the medullary collecting duct.

  6. Generation of induced pluripotent stem cells (iPSCs) from an Alzheimer's disease patient carrying a M146I mutation in PSEN1.

    Science.gov (United States)

    Li, Tong; Pires, Carlota; Nielsen, Troels T; Waldemar, Gunhild; Hjermind, Lena E; Nielsen, Jørgen E; Dinnyes, Andras; Holst, Bjørn; Hyttel, Poul; Freude, Kristine K

    2016-03-01

    Skin fibroblasts were obtained from a 46-year-old symptomatic man carrying a M146I mutation in the presenilin 1 gene (PSEN1), responsible for causing Alzheimer's disease (AD). Induced pluripotent stem cells (iPSCs) were derived via transfection with episomal vectors carrying hOCT4, hSOX2, hKLF2, hL-MYC, hLIN28 and shTP53 genes. M146I-iPSCs were free of genomically integrated reprogramming genes, had the specific mutation but no additional genomic aberrancies, expressed the expected pluripotency markers and displayed in vitro differentiation potential to the three germ layers. The reported M146I-iPSCs line may be a useful resource for in vitro modeling of familial AD. Copyright © 2016 University of Texas at Austin Dell Medical School. Published by Elsevier B.V. All rights reserved.

  7. Generation of induced pluripotent stem cells (iPSCs) from an Alzheimer's disease patient carrying an A79V mutation in PSEN1.

    Science.gov (United States)

    Li, Tong; Pires, Carlota; Nielsen, Troels T; Waldemar, Gunhild; Hjermind, Lena E; Nielsen, Jørgen E; Dinnyes, Andras; Hyttel, Poul; Freude, Kristine K

    2016-03-01

    Skin fibroblasts were obtained from a 48-year-old presymptomatic woman carrying a A79V mutation in the presenilin 1 gene (PSEN1), causing Alzheimer's disease (AD). Induced pluripotent stem cell (iPSCs) were derived via transfection with episomal vectors carrying hOCT4, hSOX2, hKLF2, hL-MYC, hLIN28 and shTP53 genes. A79V-iPSCs were free of genomically integrated reprogramming genes, had the specific mutation but no additional genomic aberrancies, expressed the expected pluripotency markers and displayed in vitro differentiation potential to the three germ layers. The reported A79V-iPSCs line may be a useful resource for in vitro modeling of familial AD. Copyright © 2016 University of Texas at Austin Dell Medical School. Published by Elsevier B.V. All rights reserved.

  8. Generation of induced pluripotent stem cells (iPSCs from an Alzheimer's disease patient carrying a M146I mutation in PSEN1

    Directory of Open Access Journals (Sweden)

    Tong Li

    2016-03-01

    Full Text Available Skin fibroblasts were obtained from a 46-year-old symptomatic man carrying a M146I mutation in the presenilin 1 gene (PSEN1, responsible for causing Alzheimer's disease (AD. Induced pluripotent stem cells (iPSCs were derived via transfection with episomal vectors carrying hOCT4, hSOX2, hKLF2, hL-MYC, hLIN28 and shTP53 genes. M146I-iPSCs were free of genomically integrated reprogramming genes, had the specific mutation but no additional genomic aberrancies, expressed the expected pluripotency markers and displayed in vitro differentiation potential to the three germ layers. The reported M146I-iPSCs line may be a useful resource for in vitro modeling of familial AD.

  9. Generation of induced pluripotent stem cells (iPSCs from an Alzheimer's disease patient carrying an A79V mutation in PSEN1

    Directory of Open Access Journals (Sweden)

    Tong Li

    2016-03-01

    Full Text Available Skin fibroblasts were obtained from a 48-year-old presymptomatic woman carrying a A79V mutation in the presenilin 1 gene (PSEN1, causing Alzheimer's disease (AD. Induced pluripotent stem cell (iPSCs were derived via transfection with episomal vectors carrying hOCT4, hSOX2, hKLF2, hL-MYC, hLIN28 and shTP53 genes. A79V-iPSCs were free of genomically integrated reprogramming genes, had the specific mutation but no additional genomic aberrancies, expressed the expected pluripotency markers and displayed in vitro differentiation potential to the three germ layers. The reported A79V-iPSCs line may be a useful resource for in vitro modeling of familial AD.

  10. [Coexistence of some diseases and analysis of death causes based on autopsy examinations carried out in liver cirrhosis patients based on autopsy observations in 1976-1990].

    Science.gov (United States)

    Sobaniec-Lotowska, M; Barwijuk, M; Baltaziak, M; Dziecioł, J; Sulkowski, S; Debek, W; Ostapiuk, H

    1996-09-01

    The 19,094 autopsy examinations carried out between 1976-1990 revealed 698 (3.65%) case of cirrhosis, of which 64.6% were men. During the last 5 years the percentage of coexistance of hepatoma (hepatocellular carcinoma) with cirrhosis was higher 5-year periods (5.8%; 5.4%). Moreover, the same changing interrelation was observed for other malignancies and cirrhosis-higher (15%) in the last period than in the proceeding years (11.1%; 11.3%). The severity of atherosclerotic changes and coexistance of peptic ulcers, gall bladder disease and productive pulmonary tuberculosis in cirrhotic patients were also assessed. Finally the direct causes of these patients' death were discussed.

  11. Investigating a model for lecturer training that enables lecturers to plan and carry out meaningful e-learning activities

    DEFF Research Database (Denmark)

    Kjær, Christopher; Hansen, Pernille Stenkil; Christensen, Inger-Marie F.

    2014-01-01

    This paper reports on the effect of a lecturer training model in the shape of an e-learning project based on research on adult and work-based learning. A survey was conducted to explore participants’ learning experiences. Findings show high overall satisfaction, motivation and engagement. Suggest...

  12. Could the local population of the Lower Rhine delta supply the Roman army? Part 2: Modelling the carrying capacity using archaeological, palaeo-ecological and geomorphological data

    NARCIS (Netherlands)

    M. van Dinter; L.I. Kooistra; M.K. Dütting; P. van Rijn; C. Cavallo

    2014-01-01

    In this part two of a diptych of articles, we modelled and quantified the carrying capacity of the landscape and the demand and supply of the Roman army in the western Lower Rhine delta with wood and food in the period A.D. 40 - 140. The absolute volumes of the wood and food were calculated (in m³ a

  13. Investigating a model for lecturer training that enables lecturers to plan and carry out meaningful e-learning activities

    DEFF Research Database (Denmark)

    Kjær, Christopher; Hansen, Pernille Stenkil; Christensen, Inger-Marie F.

    2014-01-01

    This paper reports on the effect of a lecturer training model in the shape of an e-learning project based on research on adult and work-based learning. A survey was conducted to explore participants’ learning experiences. Findings show high overall satisfaction, motivation and engagement. Suggest......This paper reports on the effect of a lecturer training model in the shape of an e-learning project based on research on adult and work-based learning. A survey was conducted to explore participants’ learning experiences. Findings show high overall satisfaction, motivation and engagement....... Suggestions for improvement include better integration of the e-learning project with other lecturer training components, supporting participants in formulating the e-learning project and providing additional opportunities for reflection and feedback....

  14. Dynamic model of large amplitude vibration of a uniform cantilever beam carrying an intermediate lumped mass and rotary inertia

    OpenAIRE

    A. Nikkar; BAGHERI, S.; Saravi,M.

    2014-01-01

    In this paper, a mathematical model of large amplitude vibration of a uniform cantilever beam arising in the structural engineering is proposed. Two efficient and easy mathematical techniques called variational iteration method and He's variational approach are used to solve the governing differential equation of motion. To assess the accuracy of solutions, we compare the results with the Runge-Kutta 4th order. An excellent agreement of the approximate frequencies and periodic solutions with ...

  15. Correlation of the level of full-length CFTR transcript with pulmonary phenotype in patients carrying R117H and 1342-1,-2delAG mutations

    Energy Technology Data Exchange (ETDEWEB)

    Hamosh, A.; Cutting, G.R. [Johns Hopkins Univ. School of Medicine, Balitmore, MD (United States); Oates, R.; Amos, J. [Boston Univ. School of Medicine, Boston, MA (United States)

    1994-09-01

    The R117H mutation occurs on two chromosome backgrounds, one associated with a 7 thymidine tract (7T-R11H) in the splice-acceptor site of intron 8, the other with a 5 thymidine tract (5T-R117H). We examined exon 9 splicing efficiency in 5 patients of genotype R117H/{delta}F508 and one carrying 1342-1,-2delAG{delta}F508, an obligate exon 9 slice site mutation. Four patients carried R117H on a 7T background -- three adult men with congenital bilateral absence of the vas deferens and one adolescent female with pancreatitis and borderline sweat chloride concentration. The patient with R117H on a 5T background had pancreatic sufficient CF (PS-CF). The 1342-1,-2delAG patient has classic pancreatic insufficient CF (PI-CF). cDNA was synthesized from total RNA extracted from nasal epithlial cells and analyzed for CFTR splicing by 35 cycle PCR using primers in exon 7 and 11. The quantity of full length transcript derived from the R117H or {delta}F508 alleles was assessed by allele-specific oligonucleotide hybridization. While 91.4% of transcript from the 5T-R117H allele was full-length, only 42.2% of CFTR transcript from the 5T-R117H allele was full length. Since CBAVD patients have no lung disease and PS-CF patients do, this indicates that the threshold of developing CF lung disease is crossed when the amount of CFTR transcript bearing R117H is reduced by half. Interestingly, 17.1% of transcript derived from the 1342-1,-2delAG allele (or 8.6% of total CFTR transcript) was normal and full length. This suggests that up to 9% of full length wild-type CFTR transcript may be inadequate to escape the lung disease of CF and that a 9 thymidine tract followed by AAC (the result of the AG deletion) can be used as a splice donor with 2-9% efficiency.

  16. Frequency and phenotype of patients carrying TPM2 and TPM3 gene mutations in a cohort of 94 patients with congenital myopathy

    DEFF Research Database (Denmark)

    Citirak, Gülsenay; Witting, Nanna; Duno, Morten

    2014-01-01

    , physical performance and joint contractures. The variation in clinical profiles emphasizes the phenotypic heterogeneity. However, common features were also present, such as onset of symptoms in infancy or childhood, musculoskeletal deformities and normal or low plasma levels of creatine kinase. One patient...

  17. High Incidence of Noonan Syndrome Features Including Short Stature and Pulmonic Stenosis in Patients carrying NF1 Missense Mutations Affecting p.Arg1809: Genotype-Phenotype Correlation.

    Science.gov (United States)

    Rojnueangnit, Kitiwan; Xie, Jing; Gomes, Alicia; Sharp, Angela; Callens, Tom; Chen, Yunjia; Liu, Ying; Cochran, Meagan; Abbott, Mary-Alice; Atkin, Joan; Babovic-Vuksanovic, Dusica; Barnett, Christopher P; Crenshaw, Melissa; Bartholomew, Dennis W; Basel, Lina; Bellus, Gary; Ben-Shachar, Shay; Bialer, Martin G; Bick, David; Blumberg, Bruce; Cortes, Fanny; David, Karen L; Destree, Anne; Duat-Rodriguez, Anna; Earl, Dawn; Escobar, Luis; Eswara, Marthanda; Ezquieta, Begona; Frayling, Ian M; Frydman, Moshe; Gardner, Kathy; Gripp, Karen W; Hernández-Chico, Concepcion; Heyrman, Kurt; Ibrahim, Jennifer; Janssens, Sandra; Keena, Beth A; Llano-Rivas, Isabel; Leppig, Kathy; McDonald, Marie; Misra, Vinod K; Mulbury, Jennifer; Narayanan, Vinodh; Orenstein, Naama; Galvin-Parton, Patricia; Pedro, Helio; Pivnick, Eniko K; Powell, Cynthia M; Randolph, Linda; Raskin, Salmo; Rosell, Jordi; Rubin, Karol; Seashore, Margretta; Schaaf, Christian P; Scheuerle, Angela; Schultz, Meredith; Schorry, Elizabeth; Schnur, Rhonda; Siqveland, Elizabeth; Tkachuk, Amanda; Tonsgard, James; Upadhyaya, Meena; Verma, Ishwar C; Wallace, Stephanie; Williams, Charles; Zackai, Elaine; Zonana, Jonathan; Lazaro, Conxi; Claes, Kathleen; Korf, Bruce; Martin, Yolanda; Legius, Eric; Messiaen, Ludwine

    2015-11-01

    Neurofibromatosis type 1 (NF1) is one of the most frequent genetic disorders, affecting 1:3,000 worldwide. Identification of genotype-phenotype correlations is challenging because of the wide range clinical variability, the progressive nature of the disorder, and extreme diversity of the mutational spectrum. We report 136 individuals with a distinct phenotype carrying one of five different NF1 missense mutations affecting p.Arg1809. Patients presented with multiple café-au-lait macules (CALM) with or without freckling and Lisch nodules, but no externally visible plexiform neurofibromas or clear cutaneous neurofibromas were found. About 25% of the individuals had Noonan-like features. Pulmonic stenosis and short stature were significantly more prevalent compared with classic cohorts (P NF1-patient showed two different somatic NF1 mutations, p.Arg1809Cys and a multi-exon deletion, providing genetic evidence that p.Arg1809Cys is a loss-of-function mutation in the melanocytes and causes a pigmentary phenotype. Constitutional missense mutations at p.Arg1809 affect 1.23% of unrelated NF1 probands in the UAB cohort, therefore this specific NF1 genotype-phenotype correlation will affect counseling and management of a significant number of patients.

  18. Treatment by strontium of a dialysed patient carrying painful osseous metastases; Traitement par le strontium d`un malade dialyse porteur de metastases osseouses douloureuses

    Energy Technology Data Exchange (ETDEWEB)

    Malezieux, X.; Irlinger, P. [Service de Medecine Nucleaire, Hopital Pasteur 68024 COLMAR (France); Boess, G. [Service de Nephrologie, Hopital Pasteur 68024 COLMAR (France)

    1997-12-31

    We have accomplished a treatment by strontium 89 chloride in a chronic dialysed patient, 74 years old, carrying very plentiful multiple osseous metastases. One hundred and forty eight MBq (4 mCi) of strontium 89 chloride was administrated intra-venously. The eviction of {sup 89}Sr was determined for the two dialyses which followed the therapy (after 50 and 130 hours, respectively) and the circulating residual activity was measured by using the activity of total blood samples (30 min, 8, 24 and 48 hours after administration) making use of the Bremsstrahlung radiation. The blood activity at 24 and 48 hours is 50% lower than the activity at 30 minutes. The activity eliminated by the second dialysis is a half lower than that o first dialysis. The most radioactivity is eliminated during the first minutes of dialysis as the activity at the end of each dialyses is as low as 5% of that at the beginning. The contamination of the dialysis machine is insignificant and it can be used again after a simple wash. No side effect of the therapy was found in the treated patient. The pains diminished spectacularly during 3 month, a 10% diminution of platelets rate has been observed and no modification of the white formula. This example shows the possibility of treating successfully patients under dialysis with strontium 89 chloride

  19. GIS and agent based spatial-temporal simulation modeling for assessing tourism social carrying capacity: a study on Mount Emei scenic area, China

    Science.gov (United States)

    Zhang, Renjun

    2007-06-01

    Each scenic area can sustain a specific level of acceptance of tourist development and use, beyond which further development can result in socio-cultural deterioration or a decline in the quality of the experience gained by visitors. This specific level is called carrying capacity. Social carrying capacity can be defined as the maximum level of use (in terms of numbers and activities) that can be absorbed by an area without an unacceptable decline in the quality of experience of visitors and without an unacceptable adverse impact on the society of the area. It is difficult to assess the carrying capacity, because the carrying capacity is determined by not only the number of visitors, but also the time, the type of the recreation, the characters of each individual and the physical environment. The objective of this study is to build a spatial-temporal simulation model to simulate the spatial-temporal distribution of tourists. This model is a tourist spatial behaviors simulator (TSBS). Based on TSBS, the changes of each visitor's travel patterns such as location, cost, and other states data are recoded in a state table. By analyzing this table, the intensity of the tourist use in any area can be calculated; the changes of the quality of tourism experience can be quantized and analyzed. So based on this micro simulation method the social carrying capacity can be assessed more accurately, can be monitored proactively and managed adaptively. In this paper, the carrying capacity of Mount Emei scenic area is analyzed as followed: The author selected the intensity of the crowd as the monitoring Indicators. it is regarded that longer waiting time means more crowded. TSBS was used to simulate the spatial-temporal distribution of tourists. the average of waiting time all the visitors is calculated. And then the author assessed the social carrying capacity of Mount Emei scenic area, found the key factors have impacted on social carrying capacity. The results show that the TSBS

  20. Generation of induced pluripotent stem cells (iPSCs from a Bernard–Soulier syndrome patient carrying a W71R mutation in the GPIX gene

    Directory of Open Access Journals (Sweden)

    Lourdes Lopez-Onieva

    2016-05-01

    Full Text Available We generated an induced pluripotent stem cell (iPSC line from a Bernard–Soulier Syndrome (BSS patient carrying the mutation p.Trp71Arg in the GPIX locus (BSS1-PBMC-iPS4F4. Peripheral blood mononuclear cells (PBMCs were reprogrammed using heat sensitive non-integrative Sendai viruses containing the reprogramming factors Oct3/4, SOX2, KLF4 and c-MYC. Successful silencing of the exogenous reprogramming factors was checked by RT-PCR. Characterization of BSS1-PBMC-iPS4F4 included mutation analysis of GPIX locus, Short Tandem Repeats (STR profiling, alkaline phosphatase enzymatic activity, analysis of conventional pluripotency-associated factors at mRNA and protein level and in vivo differentiation studies. BSS1-PBMC-iPS4F4 will provide a powerful tool to study BSS.

  1. How to carry out the communication between nurses and patients%如何进行护患间的沟通

    Institute of Scientific and Technical Information of China (English)

    许桂从

    2013-01-01

    在新的医学模式下,患者对医疗护理的质量提出了更高的标准和高要求,在这种形式下,护士和患者之间的沟通尤其显得重要。良好的护患关系能使患者感到护理工作者的爱心、关心、热情,可以帮助病人建立良好的自信、增加患者对护理人员的信任感、促进疾病的早日康复。文章从职业道德、仪表及体态语言、交际语言、患者的信息收集和信息跟踪四个方面谈护患之间沟通的体会。%under the new medical model,put forward in the quality of medical care in patients with higher standard and higher requirements, under this form of communication between nurses and patients is particularly important. Good relationship between nurses and patients can make patients feel care workers of love,care and enthusiasm,can help patients to establish good confidence,increase patients' trust of nursing staff, promote disease recover at an early date.The article from the professional ethics,instrument and body language,language communication,the patient's information col ection and information tracking four aspects about the communication between nurses and patients.

  2. Assessing the effect of interventions on the risk of cattle and sheep carrying Escherichia coli O157:H7 to the abattoir using a stochastic model.

    Science.gov (United States)

    Stacey, K F; Parsons, D J; Christiansen, K H; Burton, C H

    2007-04-16

    Escherichia coli O157:H7 persists in being a threat to food safety. The mechanisms behind the spread of E. coli O157:H7 on the farm are complex and poorly understood. The objective of this study was to apply a Monte Carlo model, constructed to simulate the propagation of E. coli O157:H7 in cattle and sheep on the farm, to both test the effect of different interventions on the risk of animals carrying E. coli O157:H7 to the abattoir and to develop understanding of the underlying processes, including the identification of areas that could benefit from further research. An overview of the model including key assumptions is given. The output statistics from batches of 100 runs of the model were collected. From the model output, a cumulative frequency distribution of the prevalence and specific shedding level for the groups of cattle or sheep being sent to the abattoir were generated. Stochastic dominance was used to compare the results of the model outputs. Using the shorthand that "risk" means the likelihood of carrying E. coli O157:H7 to the abattoir, key conclusions from the study included: mixing sheep and cattle increases the risk in both groups; merging groups of animals of the same species into larger groups increases the risk substantially; increasing stocking density increases the risk independently of group size; decreasing the group size decreases the E. coli O157:H7 prevalence independently of stocking density; a very high level of barn hygiene reduces the risk; a shorter time between spreading farmyard manure and grazing and an increased background level of E. coli O157:H7 in the model increases the risk. The background level could be influenced by the presence of wild animals carrying the organism. The parameters to which the model is most sensitive are those related to transmission from grass and enclosures to animals, pathogen survival on grass, in slurry and in barns and contact between animals.

  3. 资源与环境承载力综合评价模型研究%The Comprehensive Evaluation Model of Resources and Environmental Carrying Capability

    Institute of Scientific and Technical Information of China (English)

    柴国平; 徐明德; 王帆; 左婵

    2014-01-01

    Over-exploitation of resources resulting in environment severely damaged, making the resources and environmental carrying capacity declined significantly. Research on carrying capacity of resources and environ-ment has become popular and a trend in ecological environment research. Moreover, it has great significance to economic activity of human society. Regarding resource and environment as a complex ecological system, this article established the integrated index system of resources and environmental carrying capacity based on multi-level structure of target layer-criterion layer-index layer, which contains three criteria level indicators, eight integrated indicators and the integration of a series of basic indicators index system with the resources and environmental carrying capacity as the target layer. Through a comprehensive analysis of the linkages between indicators and their contribution to the overall goal, several integrated indicators model, socio-economic develop-ment level model, resources carrying capacity model, environmental vulnerability degree model, resources and environmental carrying capacity composite index model was constructed. Regarding grid which distributed even-ly and continuously with the same size as the basic unit of analysis, a systematic and quantitative techniques methodology was formed through the use of GIS technique. In addition, calculation of index data in grid cells and visualization of the resources and environmental carrying capacity was achieved. The results reflected the continuity and gradual change of spatial distribution of resources and environmental carrying capacity, improved the mutability generated by administrative divisions, i.e. the unit of analysis. By the empirical analysis of Yang-gao County in Shanxi Province, the validity and operability of the model and method was verified due to the con-sistency of the results with the actual situation.%资源与环境承载力的研究对人类社会经济活动意义

  4. Analysis of Sister Carrie

    Institute of Scientific and Technical Information of China (English)

    孙淑珍

    2004-01-01

    Chapter Ⅰ Introduction  Sitting in the rocking chair,Carrie dreams her future.This is the deep impression the novel"Sister Carrie"gives us,which is written by Theodore Dreiser(1871-1945),the great American realism writer.  ……

  5. Assessment of water ecological carrying capacity under the two policies in Tieling City on the basis of the integrated system dynamics model.

    Science.gov (United States)

    Wang, Shuo; Xu, Ling; Yang, Fenglin; Wang, He

    2014-02-15

    Considering the limitation of the traditional method to assess the ecological carrying capacity and the complexity of the water ecological system, we used system dynamics, ANN, and CA-Markov to model a water ecological system. The social component was modeled according to Granger causality test by system dynamics. The natural component consists of the water resource and water environmental capacity, which were forecasted through the prediction of precipitation and change in land use cover. The interaction of the social component and the natural component mainly reflected environmental policies, such as the imposition of an environmental fee and environmental tax based on their values. Simulation results showed the different assessments on water ecological carrying capacity under the two policies. The population grew (2.9 million), and less pollution (86,632.37 t COD and 2854.5 t NH4N) was observed with the imposition of environmental tax compared with the imposition of an environmental fee (2.85 million population, 10,8381 t COD and 3543 t NH4N) at the same GDP level of 585 billion CNY in 2030. According to the causality loop, we discussed the different states under the policies and the reasons that caused the differences in water ecological carrying capacity state. According to game theory, we explained the limitation of the environmental fee policy on the basis of marginal benefit and cost. The externality was cleared up by the environmental tax policy. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. A model to assess fundamental and realized carrying capacities of island ecosystem: A case study in the southern Miaodao Archipelago of China

    Institute of Scientific and Technical Information of China (English)

    SHI Honghua; SHEN Chengcheng; ZHENG Wei; LI Fen; WANG Xiaoli; CHI Yuan; GUO Zhen

    2016-01-01

    Research on carrying capacity, aiming at maintaining the limited ability of the Earth's life supporting system to sustain human development, requires a comprehensive and ecosystem-based approach to monitor and assess the localized sustainability of coupled social and ecological systems. A definition termed the ecosystem-based carrying capacity of island (EBCCI) was developed in this paper of which the indices of fundamental and realized carrying capacities of island (FCCI and RCCI) were highlighted to emphasize the inter-dependencies between social systems and ecological systems. In order to avoid the difficulties and uncertainties of direct assessment, the related assessment model was established on the basis of synthetic evaluation of inherent and external factors affecting the EBCCI. The southern Miaodao Archipelago (SMA) located in the intersection of the Bohai Sea and the Yellow Sea, China, was taken as a typical example to acquire integrated recognition of the island ecosystem and its carrying capacity so as to discuss its sustainable development. The index scores of FCCI and RCCI in the SMA were 0.818 5 and 0.712 9 out of 1.0, respectively, with acceptable uncertainties. The results showed a relatively well capacity to sustain progress and relatively well realization of the carrying capacity of island ecosystem, owing to a well capacity of ecologically regulating, general performance of both ecologically supporting and resource provisioning, and a relatively high level of social supporting system. The study implied that it was critical to optimize the inter-dependencies and to sustain the relative balance between social systems and ecological systems so as to improve the RCCI and further facilitate the sustainability of SMA. The approach proposed in this paper provides a powerful tool which is well applicative to the regional level of an oceanic island or archipelago to study the sustainable development and can be further popularized to the coastal zone.

  7. Sequential isolation in a patient of Raoultella planticola and Escherichia coli bearing a novel ISCR1 element carrying blaNDM-1.

    Directory of Open Access Journals (Sweden)

    Juan Li

    Full Text Available BACKGROUND: The gene for New Delhi metallo-β-lactamase 1 (NDM-1 has been reported to be transmitted via plasmids which are easily transferable and capable of wide distribution. We report the isolation of two NDM-1 producing strains and possible in vivo transfer of blaNDM-1 in a patient. METHODS: Clinical samples were collected for bacterial culture and antibiotic susceptibility testing from a patient during a 34-day hospitalization. The presence of blaNDM-1 was detected by PCR and sequencing. Plasmids of interest were sequenced. Medical records were reviewed for evidence of association between the administration of antibiotics and the acquisition of the NDM-1 resistance. RESULTS: A NDM-1 positive Raoultella planticola was isolated from blood on the ninth day of hospitalization without administration of any carbapenem antibiotics and a NDM-1 positive Escherichia coli was isolated from feces on the 29th day of hospitalization and eight days after imipenem administration. The blaNDM-1 was carried by a 280 kb plasmid pRpNDM1-1 in R. planticola and a 58 kb plasmid pEcNDM1-4 in E. coli. The two plasmids shared a 4812 bp NDM-1-ISCR1 element which was found to be excisable from the plasmid as a free form and transferrable in vitro to a NDM-1 negative plasmid from E. coli. CONCLUSION: blaNDM-1 was embedded in an ISCR1 complex class 1 integron as a novel 4812 bp NDM-1-ISCR1 element. The element was found to be able to self excise to become a free form, which may provide a new vehicle for NDM-1 dissemination. This mechanism could greatly accelerate the spread of NDM-1 mediated broad spectrum β-lactam resistance.

  8. Secondary amyloidosis in a patient carrying mutations in the familial Mediterranean fever (FMF) and tumour necrosis factor receptor-1 syndrome (TRAPS) genes.

    Science.gov (United States)

    Clementi, Anna; Cruz, Dinna N; Granata, Antonio; Virzì, Grazia Maria; Battaglia, Giorgio

    2013-12-01

    Secondary amyloidosis (AA) is characterized by the extracellular tissue deposition of fibrils composed of fragments of an acute-phase reactant protein, serum amyloid A (SAA), due to chronic inflammatory diseases, infections and several neoplasms. AA amyloidosis may also complicate several hereditary diseases, where genetic factors play a pivotal role in the expression of amyloidosis. Familial Mediterranean fever (FMF) and tumour necrosis factor receptor-1 syndrome (TRAPS) are the most frequently involved. We describe a case of a 21-year-old Romanian woman who presented at the 35th week of gestation with acute abdominal pain, nausea and vomiting. The laboratory workup performed after delivery showed proteinuria in the nephrotic range and increased SAA protein. Kidney amyloid deposits were detected and genetic testing for secondary amyloidosis was performed identifying two mutations, one involving the gene of FMF (MEFV), and the other involving the tumour necrosis factor receptor-1 gene (TNFRSF1A). To our knowledge, this is the first case in the literature where secondary amyloidosis develops in a patient carrying mutations involving the genes of both FMF and TRAPS.

  9. A refined integro-surface energy-based model for vibration of magnetically actuated double-nanowire-systems carrying electric current

    Science.gov (United States)

    Kiani, Keivan

    2017-02-01

    A novel surface energy-based model is developed to examine more precisely vibrations of current-carrying double-nanowire-systems immersed in a longitudinal magnetic field. Using Biot-Savart and Lorentz laws, a more refined version of interwire interactional magnetic forces is presented. By employing Rayleigh beam theory, the equations of motion are derived. In fact, these are coupled integro-differential equations which are more accurate with respect to those of the previously developed models. For simply supported and clamped nanosystems, governing equations are analyzed via assumed mode method. The effects of interwire distance, slenderness ratio, electric current, magnetic field strength, and surface effect on the fundamental frequency are addressed carefully. The obtained results display the importance of exploiting the refined model for vibration analysis of nanosystems with low interwire distance, high electric current, and high magnetic field strength.

  10. Relationship between histopathological status of the Helicobacter pylori infected patients and proteases of H. pylori in isolates carrying diverse virulence genotypes.

    Science.gov (United States)

    Gharibi, Somayyeh; Falsafi, Tahereh; Alebouyeh, Masoud; Farzi, Nastaran; Vaziri, Farzam; Zali, Mohamad Reza

    2017-09-01

    Helicobacter pylori is the main cause of several gastroduodenal diseases in Humans. Among various virulence factors of H. pylori, proteases may also be involved in its pathogenicity. In this study, relationship between proteolytic activity of H. pylori strains and histopathological changes of the stomach was investigated in the patients infected with strains carrying diverse virulence factors. H. pylori strains were isolated from the biopsies of 116 patients who referred to hospital for their gastroduodenal disorders, in Tehran, Iran. Biopsies were sent to microbiology and pathology laboratories for further analysis. All the suspected grown colonies were characterized by both biochemical tests and polymerase chain reaction (PCR). Presence of seven protease genes, htrA, clpP, hp0169, hp1012, hp0382, hp1350 and hp1435, and distinct allelic variants of H. pylori virulence factors, cagA, vacA, iceA, babA2 and sabA, were analyzed in each strain. Protease activity of the strains was assessed using spectrophotometric assay. Furthermore, association between diversity in protease genes and virulence genes, protease activity, as well as pathological changes was estimated statistically. Proteases genes, htrA, clpP, hp0169, hp1012, hp0382, hp1350, hp1435, were detected among 100%, 100%, 98%, 98%, 98%, 98%, and 8% of fifty H. pylori strains isolated from the patients, respectively. Status of cagA, vacA s1, vacA s2, vacA m1, vacA m2, iceA1, iceA2, babA2 and sabA genes in isolates were 64%, 68%, 30%, 26%, 74%, 48%, 52%, 100%, and 96%, respectively. Predominant (84%) combined status for protease genes was: htrA/clpP/hp0169/hp1012/hp0382/hP1350/hp1435, while the prevalent combined status (16%) for virulence genes was: cagA+/vacA s1m2/iceA1(+)/sabA(+)/babA2(+). Although most of the strains (91.4%) presented moderate protease activity in vitro, lowest activity was measured in strains isolated from the patients with chronic gastritis (4.25%). Present study provide the new data

  11. High-Quality Genome Sequence of an Escherichia coli O157 Strain Carrying an mcr-1 Resistance Gene Isolated from a Patient in the United States.

    Science.gov (United States)

    Lindsey, Rebecca L; Batra, Dhwani; Rowe, Lori; Loparev, Vladimir N; Stripling, Devon; Garcia-Toledo, Lisley; Knipe, Kristen; Juieng, Phalasy; Sheth, Mili; Martin, Haley; Laufer Halpin, Alison

    2017-03-16

    Enterobacteriaceae carrying plasmid-mediated colistin resistance have been found around the world. We report here the high-quality whole-genome sequence of an Escherichia coli O157:H48 isolate (2016C-3936C1) from Connecticut that carried the mcr-1 resistance gene on an IncX4-type plasmid. Copyright © 2017 Lindsey et al.

  12. Generation of induced pluripotent stem cells (iPSCs) from an Alzheimer's disease patient carrying an A79V mutation in PSEN1

    DEFF Research Database (Denmark)

    Li, Tong; Pires, Carlota; Nielsen, Troels T.

    2016-01-01

    Skin fibroblasts were obtained from a 48-year-old presymptomatic woman carrying a A79V mutation in the presenilin 1 gene (PSEN1), causing Alzheimer's disease (AD). Induced pluripotent stem cell (iPSCs) were derived via transfection with episomal vectors carrying hOCT4, hSOX2, hKLF2, hL-MYC, hLIN28...

  13. Generation of induced pluripotent stem cells (iPSCs) from an Alzheimer's disease patient carrying a M146I mutation in PSEN1

    DEFF Research Database (Denmark)

    Li, Tong; Pires, Carlota; Nielsen, Troels Tolstrup

    2016-01-01

    Skin fibroblasts were obtained from a 46-year-old symptomatic man carrying a M146I mutation in the presenilin 1 gene (PSEN1), responsible for causing Alzheimer's disease (AD). Induced pluripotent stem cells (iPSCs) were derived via transfection with episomal vectors carrying hOCT4, hSOX2, hKLF2, ...

  14. Functional abnormalities in iPSC-derived cardiomyocytes generated from CPVT1 and CPVT2 patients carrying ryanodine or calsequestrin mutations.

    Science.gov (United States)

    Novak, Atara; Barad, Lili; Lorber, Avraham; Gherghiceanu, Mihaela; Reiter, Irina; Eisen, Binyamin; Eldor, Liron; Itskovitz-Eldor, Joseph; Eldar, Michael; Arad, Michael; Binah, Ofer

    2015-08-01

    Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited arrhythmia characterized by syncope and sudden death occurring during exercise or acute emotion. CPVT is caused by abnormal intracellular Ca(2+) handling resulting from mutations in the RyR2 or CASQ2 genes. Because CASQ2 and RyR2 are involved in different aspects of the excitation-contraction coupling process, we hypothesized that these mutations are associated with different functional and intracellular Ca(²+) abnormalities. To test the hypothesis we generated induced Pluripotent Stem Cell-derived cardiomyocytes (iPSC-CM) from CPVT1 and CPVT2 patients carrying the RyR2(R420Q) and CASQ2(D307H) mutations, respectively, and investigated in CPVT1 and CPVT2 iPSC-CM (compared to control): (i) The ultrastructural features; (ii) the effects of isoproterenol, caffeine and ryanodine on the [Ca(2+) ]i transient characteristics. Our major findings were: (i) Ultrastructurally, CASQ2 and RyR2 mutated cardiomyocytes were less developed than control cardiomyocytes. (ii) While in control iPSC-CM isoproterenol caused positive inotropic and lusitropic effects, in the mutated cardiomyocytes isoproterenol was either ineffective, caused arrhythmias, or markedly increased diastolic [Ca(2+) ]i . Importantly, positive inotropic and lusitropic effects were not induced in mutated cardiomyocytes. (iii) The effects of caffeine and ryanodine in mutated cardiomyocytes differed from control cardiomyocytes. Our results show that iPSC-CM are useful for investigating the similarities/differences in the pathophysiological consequences of RyR2 versus CASQ2 mutations underlying CPVT1 and CPVT2 syndromes.

  15. Human embryonic stem cells carrying an unbalanced translocation demonstrate impaired differentiation into trophoblasts: an in vitro model of human implantation failure.

    Science.gov (United States)

    Shpiz, A; Kalma, Y; Frumkin, T; Telias, M; Carmon, A; Amit, A; Ben-Yosef, D

    2015-03-01

    Carriers of the balanced translocation t(11;22), the most common reciprocal translocation in humans, are at high risk of creating gametes with unbalanced translocation, leading to repeated miscarriages. Current research models for studying translocated embryos and the biological basis for their implantation failure are limited. The aim of this study was to elucidate whether human embryonic stem cells (hESCs) carrying the unbalanced chromosomal translocation t(11;22) can provide an explanation for repeated miscarriages of unbalanced translocated embryos. Fluorescent in situ hybridization and karyotype analysis were performed to analyze the t(11;22) in embryos during PGD and in the derived hESC line. The hESC line was characterized by RT-PCR and FACS analysis for pluripotent markers. Directed differentiation to trophoblasts was carried out by bone morphogenetic protein 4 (BMP4). Trophoblast development was analyzed by measuring β-hCG secretion, by β-hCG immunostaining and by gene expression of trophoblastic markers. We derived the first hESC line carrying unbalanced t(11;22), which showed the typical morphological and molecular characteristics of a hESC line. Control hESCs differentiated into trophoblasts secreted increasing levels of β-hCG and concomitantly expressed the trophoblast genes, CDX2, TP63, KRT7, ERVW1, CGA, GCM1, KLF4 and PPARG. In contrast, differentiated translocated hESCs displayed reduced and delayed secretion of β-hCG concomitant with impaired expression of the trophoblastic genes. The reduced activation of trophoblastic genes may be responsible for the impaired trophoblastic differentiation in t(11;22)-hESCs, associated with implantation failure in unbalanced t(11;22) embryos. Our t(11;22) hESCs are presented as a valuable human model for studying the mechanisms underlying implantation failure.

  16. Sister Carrie in China

    Institute of Scientific and Technical Information of China (English)

    殷希

    2015-01-01

    Sister Carrie has received many Chinese scholar's attention, and it has quantity relevance researches. Therefore, it is valuable to study why it is popular in China and it's education meaning for Chinese people. In addition, to analysis the domestic re-searches and find it's exist problems can help us make a new breakthrough from the study.

  17. Contest and Scramble Competition and the Carry-Over Effect in Globodera spp. in Potato-Based Crop Rotations Using an Extended Ricker Model.

    Science.gov (United States)

    Van Den Berg, W; Rossing, W A H; Grasman, J

    2006-06-01

    The Ricker model extended with a linear term was used to model the dynamics of a potato cyst nematode population on different potato cultivars over a wide range of population densities. The model accounts for contest and scramble competition and between-year carryover of unhatched eggs. Contest competition occurs due to the restricted amount of available root sites that are the feeding source of the female nematode. Nematodes not reaching such a feeding site turn into males and do not contribute to a new generation. Scramble competition results in a decrease of the number of eggs per cyst at high densities due to the decrease in the food supply per feeding site. At still higher densities, the size of the root system declines; then dynamics are mostly governed by carryover of cysts between subsequent years. The restricted number of three parameters in the proposed model made it possible to calculate the equilibrium densities and to obtain analytical expressions of the model's sensitivity to parameter change. The population dynamics model was combined with a yield-loss assessment model and, using empirical Bayesian methods, was fitted to data from a 3-year experiment carried out in the Netherlands. The experiment was set up around the location of a primary infestation of Globodera pallida in reclaimed polder soil. Due to a wide range of population densities at short distances from the center of the infestation, optimal conditions existed for studying population response and damage in different cultivars. By using the empirical Bayesian methods it is possible to estimate all parameters of the dynamic system, in contrast to earlier studies with realistic biological models where convergence of parameter estimation algorithms was a problem. Applying the model to the outcome of the experiment, we calculated the minimum gross margin that a fourth crop needs to reach in order to be taken up in a 3-year rotation with potato. An equation was derived that accounted for both

  18. 基于FPGA进位链TDC延时模型的建立与性能测试%Delay Model and Performance Testing for FPGA Carry Chain TDC

    Institute of Scientific and Technical Information of China (English)

    康晓文; 刘亚强; 崔均健; 杨章灿; 金永杰

    2011-01-01

    Time- of- flight (TOF) information would improve the performance of PET (positron emission tomography). TDC design is a key technique. It proposed Carry Chain TDG Delay model. Through changing the significant delay parameter of model, paper compared the difference of TDC performance, and finally realized Time- to- Digital Convertor (TDC) based on Carry Chain Method using FPGA EP2C20Q240C8N with 69 ps LSB, max error below 2 LSB. Such result could meet the TOF demand. It also proposed a Coaxial Cable Measuring method for TDC testing , without High - precision test equipment.%引入飞行时间信息,可以提高正电子断层显像仪(Positron Ernission Tomography,PET)系统的性能.电子学时间数字转换(TDC,Time-to-Digital Convertor)设计是其中一项关键技术.论文针对进位链(Carty Chain)TDC设计,建立了TDC的延时模型,推导了进位链TDC的延时公式.基于模型,通过调整关键信号的参数,比较了调整前后的TDC性能,在EP2C20Q240C8N芯片上实现和提升了进位链TDC的性能,最小测量间隔为69 ps,测量误差小于2 LSB,能够满足TOF测量时间精度的要求,并验证了模型公式的正确性.对TDC的测试方法选用高精度同轴电缆进行间接测量,解决了在缺乏ps级高精度测试设备情况下的时间精度测试问题.

  19. Experimental determination and chemical modelling of radiolytic processes at the spent fuel/water interface. Experiments carried out in carbonate solutions in absence and presence of chloride

    Energy Technology Data Exchange (ETDEWEB)

    Bruno, Jordi; Cera, Esther; Grive, Mireia; Duro, Lara [Enviros Spain SL (Spain); Eriksen, Trygve [Royal Inst. of Tech., Stockholm (Sweden). Dept. of Nuclear Chemistry

    2003-01-01

    We report on the recent experimental and modelling results of a research programme that started in 1995. The aim has been to understand the kinetic and thermodynamic processes that control the radiolytic generation of oxidants and reductants at the spent fuel water interface and their consequences for spent fuel matrix stability and radionuclide release. This has been done by carrying out well-controlled dissolution experiments of PWR Ringhals spent fuel fragments in an initially anoxic closed system and by using different solution compositions. Experimental series started with several tests carried out with deionised water as solvent, in a second phase experiments were conducted with 10 mM bicarbonate solutions. New experimental series were set up during the last two years by using the same bicarbonate content in solutions with varying NaCl concentrations in order to ascertain the role of this ligand on the radiolytic products and its consequence for radionuclide release. The selected NaCl concentrations are in the range of 0.1 to 10 mM. Experimental data shows that uranium dissolution at early contact times is controlled by the oxidation of the UO{sub 2} matrix. This process controls the co-dissolution of most of the analysed radionuclides, including Sr, Mo, Tc, Np and surprisingly enough, Cs. In the overall the release rates for U and the matrix associated radionuclides are in the range of 10{sup -6} moles/day with a clear decreasing trend with exposure time and after 2 years the initial release rates have decreased down to 3x10{sup -8} moles/day. The solubility of the released actinides appears to be limited by the formation of An(IV) hydroxide phases, although Np concentrations in solution did not reach solubility levels during the time intervals of the present tests. No secondary solid phase appears to control the solubility of the rest of the elements.

  20. Variation in baseline factor VIII concentration in a retrospective cohort of mild/moderate hemophilia A patients carrying identical F8 mutations

    NARCIS (Netherlands)

    Loomans, J.I.; Velzen, A.S. van; Eckhardt, C.L.; Peters, M.; Makipernaa, A.; Holmstrom, M.; Brons, P.P.T.; Dors, N.; Haya, S.; Voorberg, J.; Bom, J.G. Van Der; Fijnvandraat, K.

    2017-01-01

    Essentials Factor VIII levels vary in mild and moderate hemophilia A (MHA) patients with the same mutation. We aimed to estimate the variation and determinants of factor VIII levels among MHA patients. Age and genotype explain 59% of the observed inter-individual variation in factor VIII levels.

  1. "Christian carrying goomies".

    Science.gov (United States)

    1994-01-01

    Dr. Passingan Usurup tells critics of his pragmatic approach on condom promotion that he is a Christian carrying condoms for Christ. He is head of the University of Papua New Guinea Medical Center and is credited with developing an AIDS/HIV policy for the Papua New Guinea Defence Force. The condoms were named Goomy and promoted at launching in 1992 in a blue packet under the slogan "The bond that guards." Goomy was chosen as the name because it is pidgin for rubber, chewing gum, and anything associated with rubber. Blue packets were chosen over the calls of most soldiers for a camouflage design because of its universal appeal as the color of the sea and sky and because it was the preference of women in the airlines. Once firmly ensconced in his role at the University, Usurup plans to develop a policy for students and staff and help to conduct AIDS prevention and education activities on campus. He will encourage students to test for HIV rather than highlighting the gloom and doom of infection and disease.

  2. An experimental test of stroke recovery by implanting a hyaluronic acid hydrogel carrying a Nogo receptor antibody in a rat model

    Energy Technology Data Exchange (ETDEWEB)

    Ma Jun [Biomaterials Laboratory, Department of Materials Science and Engineering, Tsinghua University, Beijing 100084 (China); Tian Weiming [Biomaterials Laboratory, Department of Materials Science and Engineering, Tsinghua University, Beijing 100084 (China); Hou Shaoping [Beijing Institute of Neuroscience, Capital University of Medical Sciences, Beijing 100054 (China); Xu Qunyuan [Beijing Institute of Neuroscience, Capital University of Medical Sciences, Beijing 100054 (China); Spector, Myron [Tissue Engineering, VA Boston Healthcare System, Harvard Medical School, Boston, MA (United States); Cui Fuzhai [Biomaterials Laboratory, Department of Materials Science and Engineering, Tsinghua University, Beijing 100084 (China)

    2007-12-15

    The objective of the study was to determine the effects of a hyaluronic-acid-based (HA-based) hydrogel implant, carrying a polyclonal antibody to the Nogo-66 receptor (NgR), on adult rats that underwent middle cerebral artery occlusion (MCAO). Behavioral tests of a forelimb-reaching task suggested that the disabled function of the impaired forelimb in this stroke model was ameliorated by the implant to a certain extent. These behavioral findings were correlated with immunohistochemical results of investigating the distribution of NgR antibody, neurofilaments (NF) and neuron-specific class III {beta}-tubulin (TuJ1) in the brain sections. The porous hydrogel functioned as a scaffold to deliver the NgR antibody, support cell migration and development. In addition, it was found NF-positive and TuJ1-positive expressions were distributed in the implanted hydrogel. Collectively, the results demonstrate the promise of the HA hydrogel as a scaffold material and the delivery vehicle of the NgR antibody for the repair of defects and the support of neural regeneration in the brain.

  3. Properties of Carry Value Transformation

    Directory of Open Access Journals (Sweden)

    Suryakanta Pal

    2012-01-01

    Full Text Available Carry Value Transformation (CVT is a model of discrete deterministic dynamical system. In the present study, it has been proved that (1 the sum of any two nonnegative integers is the same as the sum of their CVT and XOR values. (2 the number of iterations leading to either CVT=0 or XOR=0 does not exceed the maximum of the lengths of the two addenda expressed as binary strings. A similar process of addition of modified Carry Value Transformation (MCVT and XOR requires a maximum of two iterations for MCVT to be zero. (3 an equivalence relation is shown to exist on Z×Z which divides the CV table into disjoint equivalence classes.

  4. Diabetes patients requiring glucose-lowering therapy and nondiabetics with a prior myocardial infarction carry the same cardiovascular risk: a population study of 3.3 million people

    DEFF Research Database (Denmark)

    Schramm, Tina Ken; Gislason, Gunnar H; Køber, Lars

    2008-01-01

    BACKGROUND: Previous studies reveal major differences in the estimated cardiovascular risk in diabetes mellitus, including uncertainty about the risk in young patients. Therefore, large studies of well-defined populations are needed. METHODS AND RESULTS: All residents in Denmark > or = 30 years...... diabetes types. Analyses with adjustments for comorbidity, socioeconomic status, and prophylactic medical treatment showed similar results, and propensity score-based matched-pair analyses supported these findings. CONCLUSIONS: Patients requiring glucose-lowering therapy who were > or = 30 years of age...

  5. Prognosis of residual axillary disease after neoadjuvant chemotherapy in clinically node-positive breast cancer patients : Isolated tumor cells and micrometastases carry a better prognosis than macrometastases

    NARCIS (Netherlands)

    T.J.A. van Nijnatten; J.M. Simons; M. Moossdorff; L. de Munck (Linda); M.B.I. Lobbes (Marc B.I.); C. van der Pol (Carmen); L.B. Koppert (Lisa); E.J.T. Luiten (Ernest); M.L. Smidt

    2017-01-01

    markdownabstractPurpose: The aim of this study was to compare disease-free survival (DFS) and overall survival (OS) between clinically node-positive breast cancer patients, treated with neoadjuvant chemotherapy (NAC), with axillary pathologic complete response (ypN0), residual axillary isolated tumo

  6. Prognosis of residual axillary disease after neoadjuvant chemotherapy in clinically node-positive breast cancer patients: isolated tumor cells and micrometastases carry a better prognosis than macrometastases

    NARCIS (Netherlands)

    T.J.A. van Nijnatten; J.M. Simons; M. Moossdorff; L. de Munck (Linda); M.B.I. Lobbes (Marc B.I.); C. van der Pol (Carmen); L.B. Koppert (Lisa); E.J.T. Luiten (Ernest); M.L. Smidt

    2017-01-01

    markdownabstract__Purpose:__ The aim of this study was to compare disease-free survival (DFS) and overall survival (OS) between clinically node-positive breast cancer patients, treated with neoadjuvant chemotherapy (NAC), with axillary pathologic complete response (ypN0), residual axillary isolated

  7. Cognitive and clinical characteristics of patients with amyotrophic lateral sclerosis carrying a C9orf72 repeat expansion: a population-based cohort study.

    LENUS (Irish Health Repository)

    Byrne, Susan

    2012-03-01

    Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease of upper and lower motor neurons, associated with frontotemporal dementia (FTD) in about 14% of incident cases. We assessed the frequency of the recently identified C9orf72 repeat expansion in familial and apparently sporadic cases of ALS and characterised the cognitive and clinical phenotype of patients with this expansion.

  8. The relationship between tyrosine kinase inhibitor therapy and overall survival in patients with non-small cell lung cancer carrying EGFR mutations

    Institute of Scientific and Technical Information of China (English)

    Hidekazu Suzuki; Tomonori Hirashima; Norio Okamoto; Tadahiro Yamadori; Motohiro Tamiya; Naoko Morishita; Takayuki Shiroyama

    2013-01-01

    For patients with epidermal growth factor receptor (EGFR) mutation-positive lung cancer,the relationship between the dose or duration of treatment with tyrosine kinase inhibitor (TKI) and overall survival remains unclear.Here,we analyzed clinical data of 39 patients who were diagnosed with EGFR mutation-positive non-small cell lung cancer and treated with TKI,but subsequently died.Several parameters were measured in this study:overall survival; first,second,and overall TKI therapy durations;first TKI intensity (actual dose/normal dose); and TKI rate (overall TKI therapy duration/overall survival).The response rate to TKI therapy was 50%,and the median survival was 553 days.After TKI therapy failed,38.5% patients were re-challenged with TKI.We observed a moderate relationship [r =0.534,95%confidential interval (CI) =0.263 to 0.727,P < 0.001] between overall TKI therapy duration and overall survival.However,we found no relationship between overall survival and first TKI intensity (r =0.073,95%CI =-0.380 to 0.247,P =0.657) or TKI rate (r =0.0345,95% CI =-0.284 to 0.346,P =0.835).Nonsmall cell lung cancer patients with mutation-positive tumors remained on TKI therapy for,on average,33% of the overall survival time.These findings suggest that patients with EGFR mutation-positive tumors should not stick to using TKIs.

  9. Variable epitope library carrying heavily mutated survivin-derived CTL epitope variants as a new class of efficient vaccine immunogen tested in a mouse model of breast cancer.

    Science.gov (United States)

    NoeDominguez-Romero, Allan; Zamora-Alvarado, Rubén; Servín-Blanco, Rodolfo; Pérez-Hernández, Erendira G; Castrillon-Rivera, Laura E; Munguia, Maria Elena; Acero, Gonzalo; Govezensky, Tzipe; Gevorkian, Goar; Manoutcharian, Karen

    2014-01-01

    The antigenic variability of tumor cells leading to dynamic changes in cancer epitope landscape along with escape from immune surveillance by down-regulating tumor antigen expression/presentation and immune tolerance are major obstacles for the design of effective vaccines. We have developed a novel concept for immunogen construction based on introduction of massive mutations within the epitopes targeting antigenically variable pathogens and diseases. Previously, we showed that these immunogens carrying large combinatorial libraries of mutated epitope variants, termed as variable epitope libraries (VELs), induce potent, broad and long lasting CD8+IFN-γ+ T-cell response as well as HIV-neutralizing antibodies. In this proof-of-concept study, we tested immunogenic properties and anti-tumor effects of the VELs bearing survivin-derived CTL epitope (GWEPDDNPI) variants in an aggressive metastatic mouse 4T1 breast tumor model. The constructed VELs had complexities of 10,500 and 8,000 individual members, generated as combinatorial M13 phage display and synthetic peptide libraries, respectively, with structural composition GWXPXDXPI, where X is any of 20 natural amino acids. Statistically significant tumor growth inhibition was observed in BALB/c mice immunized with the VELs in both prophylactic and therapeutic settings. Vaccinated mice developed epitope-specific spleen cell and CD8+ IFN-γ+ T-cell responses that recognize more than 50% of the panel of 87 mutated epitope variants, as demonstrated in T-cell proliferation assays and FACS analysis. These data indicate the feasibility of the application of this new class of immunogens based on VEL concept as an alternative approach for the development of molecular vaccines against cancer.

  10. Dasatinib treatment can overcome imatinib and nilotinib resistance in CML patient carrying F359I mutation of BCR-ABL oncogene.

    Science.gov (United States)

    Barańska, Marta; Lewandowski, Krzysztof; Gniot, Michał; Iwoła, Małgorzata; Lewandowska, Maria; Komarnicki, Mieczysław

    2008-01-01

    Point mutations of bcr-abl tyrosine kinase are the most frequent causes of imatinib resistance in chronic myeloid leukaemia (CML) patients. In most CML cases with BCR-ABL mutations leading to imatinib resistance the second generation of tyrosine kinase inhibitors (TKI- e.g. nilotinib or dasatinib) may be effective. Here, we report a case of a CML patient who during imatinib treatment did not obtain clinical and cytogenetic response within 12 months of therapy. The sequencing of BCR-ABL kinase domains was performed and revealed the presence of a F359I point mutation (TTC-to-ATC nucleotide change leading to Phe-to-Ile amino acid substitution). After 1 month of nilotinib therapy a rapid progression of clinical symptoms was observed. In the presence of the F359I point mutation only dasatinib treatment overcame imatinib and nilotinib resistance.

  11. [Contact tracing and partner notification among a cohort of HIV-1 infected patients. A prospective study carried out in Palermo in 2012].

    Science.gov (United States)

    Dalle Nogare, Fabrizio; Di Lorenzo, Francesco; Sanfilippo, Adriana; Dalle Nogare, Ernesto Renato; Arena, Nunzia; Prestileo, Tullio

    2014-09-01

    Introduction. Contact tracing and partner notification are tools to prevent the spread of the HIV and other sexually transmitted infections. These tools protect the rights of the individual contrasting healthcare policies that encourage dangerous kinds of discrimination. Objective. Pointing out the opinion of a sample of HIV-1 infected patients about the possibility of starting a support helpdesk for contract tracing and partner notification. Design and setting. A survey about contact tracing and partner notification procedures was conducted through anonymous questionnaires filled by a sample of 110 HIV-infected patients, involved in a follow-up stage at the Infectious Diseases Outpatients Clinic from the Civic Hospital Benfratelli in Palermo. The survey took place in May 2012. Results. An efficient partner notification is considered essential, both to protect people with whom the patient has come into contact and to contribute to the reduction of HIV spread. The questions dealing with this issue recorded more than 90% of positive answers. The questions about protecting the privacy during the diagnosis notification processes enlightened that notifying the partner is always felt as a greater need compared to the risk of losing one's own privacy; in fact, the positive answers were 81%. As for the role played by the physician during the contact tracing and partner notification process, 34% of the interviewees think that the physician should ask the patient to disclose the names of partners with whom he/she had a risky behavior. Finally, as for the question concerning how partner notification should happen, the results showed that 31% of the interviewees declare to be favorable to a full mandate by the physician, while just above 25% would choose to notify it personally, even though with the physician's help. Conclusion. Overall, the survey showed that more than 70% of people interviewed are favorable to a personal notification, against 25% of the interviewees who

  12. Immune complexes in chronic Chagas disease patients are formed by exovesicles from Trypanosoma cruzi carrying the conserved MASP N-terminal region

    Science.gov (United States)

    Díaz Lozano, Isabel María; de Pablos, Luis Miguel; Longhi, Silvia Andrea; Zago, María Paola; Schijman, Alejandro Gabriel; Osuna, Antonio

    2017-03-01

    The exovesicles (EVs) are involved in pathologic host-parasite immune associations and have been recently used as biomarkers for diagnosis of infectious diseases. The release of EVs by Trypanosoma cruzi, the causative agent of Chagas disease, has recently been described, with different protein cargoes including the MASP multigene family of proteins MASPs are specific to this parasite and characterized by a conserved C-terminal (C-term) region and an N-terminal codifying for a signal peptide (SP). In this investigation, we identified immature MASP proteins containing the MASP SP in EVs secreted by the infective forms of the parasite. Those EVs are responsible for the formation of immune complexes (ICs) containing anti-MASP SP IgGs in patients with different (cardiac, digestive and asymptomatic) chronic Chagas disease manifestations. Moreover, purified EVs as well as the MASP SP inhibit the action of the complement system and also show a significant association with the humoral response in patients with digestive pathologies. These findings reveal a new route for the secretion of MASP proteins in T. cruzi, which uses EVs as vehicles for immature and misfolded proteins, forming circulating immune complexes. Such complexes could be used in the prognosis of digestive pathologies of clinical forms of Chagas disease.

  13. A prospectively randomized trial carried out by the German Hodgkin Study Group (GHSG) for elderly patients with advanced Hodgkin's disease comparing BEACOPP baseline and COPP-ABVD (study HD9elderly).

    Science.gov (United States)

    Ballova, V; Rüffer, J-U; Haverkamp, H; Pfistner, B; Müller-Hermelink, H K; Dühmke, E; Worst, P; Wilhelmy, M; Naumann, R; Hentrich, M; Eich, H T; Josting, A; Löffler, M; Diehl, V; Engert, A

    2005-01-01

    In contrast to younger patients, the prognosis of elderly patients with advanced Hodgkin's disease (HD) has not improved substantially over the last 20 years. We thus carried out a prospectively randomized study (HD9(elderly)) to compare the BEACOPP regimen in this setting against standard COPP-ABVD. Between February 1993 and 1998, 75 patients aged 66-75 years with newly diagnosed HD in advanced stages were recruited into the HD9 trial as a separate stratum (HD9(elderly)). Patients were assigned to eight alternating cycles of COPP and ABVD or eight cycles of BEACOPP in baseline doses. Radiotherapy was given to initial bulky or residual disease. In total, 68 of 75 registered patients were assessable: 26 were treated with COPP-ABVD and 42 with BEACOPP baseline. There were no significant differences between COPP-ABVD and BEACOPP in terms of complete remission (76%), overall survival (50%) and freedom from treatment failure (FFTF) (46%) at 5 years. At a median follow-up of 80 months, a total of 37 patients died: 14/26 patients (54%) treated with COPP-ABVD and 23/42 patients (55%) with BEACOPP. Two patients (8%) treated with COPP-ABVD and nine patients (21%) treated with BEACOPP died of acute toxicity. Hodgkin-specific FFTF at 5 years was 55% after COPP-ABVD and 74% after BEACOPP (P=0.13). Thus, there are no differences in survival between these regimens in elderly patients.

  14. Preliminary results of a randomized controlled trial carried out with a fixed combination of S-adenosyl-L-methionine and betaine versus amitriptyline in patients with mild depression

    Science.gov (United States)

    Di Pierro, Francesco; Settembre, Roberto

    2015-01-01

    Background S-adenosyl-L-methionine (SAMe), a safe, endogenous, pleiotropic methyl donor well known for its antidepressant role, has been assumed to have a possible role in increasing plasma levels of compounds known to be able to raise cardiovascular risk. Although the issue is still being debated, betaine (trimethylglycine), a specific methyl donor involved in the homocysteine circuit, may be able to reduce such a risk and/or, by determining a sparing effect on endogenous SAMe, may be able to improve the clinical efficiency of SAMe itself. Indeed, preliminary results have shown clinical improvement determined by an add-on therapy with betaine administered along with SAMe, versus SAMe alone, to patients affected by mild/moderate depression. Aim To evaluate the safety and antidepressant role played by the association of SAMe plus betaine versus amitriptyline administered in untreated individuals with a recent diagnosis of mild depression. Methods This small, open-label, randomized, observational study enrolled 64 individuals with a diagnosis of mild depression according to the Zung Self-Rating Depression Scale. After randomization, they were treated with either Laroxyl® (amitriptyline, 75 mg/day) or DDM Metile® (enteric-coated SAMe, 500 mg/day, plus betaine, 250 mg/day) for 12 months. Assessment of clinical scores and tolerability was performed at T=0 and after 3, 6, and 12 months. Results After 3 months, both treatments showed a small and not statistically significant improvement. After 6 and 12 months, both treated groups demonstrated a more noticeable improved response, although the group treated with SAMe plus betaine showed better results in terms of score, number of individuals in remission, and side effects. Compliance was overlapping in both treatments. Conclusion The association of SAMe plus betaine seems to be a safe and effective tool to counteract mild depression and also when used as monotherapy in subjects with a recent diagnosis. PMID:25678811

  15. Patient-Specific Modeling in Tomorrow's Medicine

    CERN Document Server

    2012-01-01

    This book reviews the frontier of research and clinical applications of Patient Specific Modeling, and provides a state-of-the-art update as well as perspectives on future directions in this exciting field. The book is useful for medical physicists, biomedical engineers and other engineers who are interested in the science and technology aspects of Patient Specific Modeling, as well as for radiologists and other medical specialists who wish to be updated about the state of implementation.

  16. On fast carry select adders

    Science.gov (United States)

    Shamanna, M.; Whitaker, S.

    1992-01-01

    This paper presents an architecture for a high-speed carry select adder with very long bit lengths utilizing a conflict-free bypass scheme. The proposed scheme has almost half the number of transistors and is faster than a conventional carry select adder. A comparative study is also made between the proposed adder and a Manchester carry chain adder which shows that the proposed scheme has the same transistor count, without suffering any performance degradation, compared to the Manchester carry chain adder.

  17. On fast carry select adders

    Science.gov (United States)

    Shamanna, M.; Whitaker, S.

    This paper presents an architecture for a high-speed carry select adder with very long bit lengths utilizing a conflict-free bypass scheme. The proposed scheme has almost half the number of transistors and is faster than a conventional carry select adder. A comparative study is also made between the proposed adder and a Manchester carry chain adder which shows that the proposed scheme has the same transistor count, without suffering any performance degradation, compared to the Manchester carry chain adder.

  18. Contest and scramble competition and the carry-over effect in Globodera spp. in potato-based crop rotations using an extended Ricker model

    NARCIS (Netherlands)

    Berg, van den W.; Rossing, W.A.H.; Grasman, J.

    2006-01-01

    The Ricker model extended with a linear term was used to model the dynamics of a potato cyst nematode population on different potato cultivars over a wide range of population densities. The model accounts for contest and scramble competition and between-year carryover of unhatched eggs. Contest

  19. Morphing patient-specific musculoskeletal models

    DEFF Research Database (Denmark)

    Rasmussen, John; Galibarov, Pavel E.; Al-Munajjed, Amir

    other conditions may require CT or MRI data. The method and its theoretical assumptions, advantages and limitations are presented, and several examples will illustrate morphing to patient-specific models. [1] Carbes S; Tørholm S; Rasmussen, J. A Detailed Twenty-six Segments Kinematic Foot model...

  20. ISLAMIC CARING MODEL ON INCREASE PATIENT SATISFACTION

    Directory of Open Access Journals (Sweden)

    Muh. Abdurrouf

    2017-04-01

    Full Text Available Introduction: Patient satisfaction was important aspect that must be considered by health service providers, patients who were not satisfied will leave the hospital and be a competitor's customers so be able caused a decrease in sales of products/services and in turn could reduce and even loss of profit, therefore, the hospital must provided the best service so that it could increase patient satisfaction. The purpose of this study was to exams the effect of Islamic caring model on increase patient satisfaction.. Method: This study was used pre-experimental design, the respondents were 31 patients in the treatment group assigned Islamic caring and 31 patients with a kontrol group that were not given Islamic caring Inpatient Surgical Sultan Agung Islamic Hospital Semarang by using consecutive sampling techniques, patient satisfaction data collected through questionnaires and analyzed with Mann-Whitney test, as for finding out the Islamic caring for patient satisfaction were analyzed with spearmen's rho test. Result: The results showed that there was a significant influence of Islamic caring for perceived disconfirmation (p=0,000 there was a perceived disconfirmation influence on patient satisfaction significantly (p=0,000, there was a significant influence of Islamic caring for patient satisfaction in the treatment group with a kontrol group (p=0.001. Discussion: Discussion of this study was Islamic caring model effect on the increase perceived disconfirmation and patient satisfaction, Perceived disconfirmation effect on patient satisfaction, patient satisfaction who given Islamic caring was increase, patients given Islamic caring had higher satisfaction levels than patients who not given Islamic caring. Suggestions put forward based on the results of the study of Islamic caring model could be applied in Sultan Agung Islamic Hospital as a model of nursing care, Islamic caring behavior can be learned and improved through training and commitment and

  1. Contest and Scramble Competition and the Carry-Over Effect in Globodera spp. in Potato-Based Crop Rotations Using an Extended Ricker Model

    OpenAIRE

    van den Berg, W.; Rossing, W.A.H.; Grasman, J.

    2006-01-01

    The Ricker model extended with a linear term was used to model the dynamics of a potato cyst nematode population on different potato cultivars over a wide range of population densities. The model accounts for contest and scramble competition and between-year carryover of unhatched eggs. Contest competition occurs due to the restricted amount of available root sites that are the feeding source of the female nematode. Nematodes not reaching such a feeding site turn into males and do not contrib...

  2. Generating patient-specific pulmonary vascular models for surgical planning

    Science.gov (United States)

    Murff, Daniel; Co-Vu, Jennifer; O'Dell, Walter G.

    2015-03-01

    Each year in the U.S., 7.4 million surgical procedures involving the major vessels are performed. Many of our patients require multiple surgeries, and many of the procedures include "surgical exploration". Procedures of this kind come with a significant amount of risk, carrying up to a 17.4% predicted mortality rate. This is especially concerning for our target population of pediatric patients with congenital abnormalities of the heart and major pulmonary vessels. This paper offers a novel approach to surgical planning which includes studying virtual and physical models of pulmonary vasculature of an individual patient before operation obtained from conventional 3D X-ray computed tomography (CT) scans of the chest. These models would provide clinicians with a non-invasive, intricately detailed representation of patient anatomy, and could reduce the need for invasive planning procedures such as exploratory surgery. Researchers involved in the AirPROM project have already demonstrated the utility of virtual and physical models in treatment planning of the airways of the chest. Clinicians have acknowledged the potential benefit from such a technology. A method for creating patient-derived physical models is demonstrated on pulmonary vasculature extracted from a CT scan with contrast of an adult human. Using a modified version of the NIH ImageJ program, a series of image processing functions are used to extract and mathematically reconstruct the vasculature tree structures of interest. An auto-generated STL file is sent to a 3D printer to create a physical model of the major pulmonary vasculature generated from 3D CT scans of patients.

  3. Redundancy-aware topic modeling for patient record notes.

    Directory of Open Access Journals (Sweden)

    Raphael Cohen

    Full Text Available The clinical notes in a given patient record contain much redundancy, in large part due to clinicians' documentation habit of copying from previous notes in the record and pasting into a new note. Previous work has shown that this redundancy has a negative impact on the quality of text mining and topic modeling in particular. In this paper we describe a novel variant of Latent Dirichlet Allocation (LDA topic modeling, Red-LDA, which takes into account the inherent redundancy of patient records when modeling content of clinical notes. To assess the value of Red-LDA, we experiment with three baselines and our novel redundancy-aware topic modeling method: given a large collection of patient records, (i apply vanilla LDA to all documents in all input records; (ii identify and remove all redundancy by chosing a single representative document for each record as input to LDA; (iii identify and remove all redundant paragraphs in each record, leaving partial, non-redundant documents as input to LDA; and (iv apply Red-LDA to all documents in all input records. Both quantitative evaluation carried out through log-likelihood on held-out data and topic coherence of produced topics and qualitative assessment of topics carried out by physicians show that Red-LDA produces superior models to all three baseline strategies. This research contributes to the emerging field of understanding the characteristics of the electronic health record and how to account for them in the framework of data mining. The code for the two redundancy-elimination baselines and Red-LDA is made publicly available to the community.

  4. Analytical modeling of large amplitude free vibration of non-uniform beams carrying a both transversely and axially eccentric tip mass

    Science.gov (United States)

    Malaeke, Hasan; Moeenfard, Hamid

    2016-03-01

    The objective of this paper is to study large amplitude flexural-extensional free vibration of non-uniform cantilever beams carrying a both transversely and axially eccentric tip mass. The effects of variable axial force is also taken into account. Hamilton's principle is utilized to obtain the partial differential equations governing the nonlinear vibration of the system as well as the corresponding boundary conditions. A numerical finite difference scheme is proposed to find the natural frequencies and mode shapes of the system which is validated specifically for a beam with linearly varying cross section. Using a single mode approximation in conjunction with the Lagrange method, the governing equations are reduced to a set of two nonlinear ordinary differential equations in terms of end displacement components of the beam which are coupled due to the presence of the transverse eccentricity. These temporal coupled equations are then solved analytically using the multiple time scales perturbation technique. The obtained analytical results are compared with the numerical ones and excellent agreement is observed. The qualitative and quantitative knowledge resulting from this research is expected to enable the study of the effects of eccentric tip mass and non-uniformity on the large amplitude flexural-extensional vibration of beams for improved dynamic performance.

  5. An Analysis of English Carrie

    Institute of Scientific and Technical Information of China (English)

    孙淑珍

    2004-01-01

    @@ Chapter Ⅰ Introduction Sitting in the rocking chair,Carrie dreams her future.This is the deep impression the novel"Sister Carrie"gives us,which is written by Theodore Dreiser(1871-1945),the great American realism writer.

  6. An Evaluation of the Instruction Carried out with Printed Laboratory Materials Designed in Accordance with 5E Model: Reflection of Light and Image on a Plane Mirror

    Science.gov (United States)

    Ayvaci, Hakan Sevki; Yildiz, Mehmet; Bakirci, Hasan

    2015-01-01

    This study employed a print laboratory material based on 5E model of constructivist learning approach to teach reflection of light and Image on a Plane Mirror. The effect of the instruction which conducted with the designed print laboratory material on academic achievements of prospective science and technology teachers and their attitudes towards…

  7. Identification of disrupted AUTS2 and EPHA6 genes by array painting in a patient carrying a de novo balanced translocation t(3;7) with intellectual disability and neurodevelopment disorder.

    Science.gov (United States)

    Schneider, Anouck; Puechberty, Jacques; Ng, Bee Ling; Coubes, Christine; Gatinois, Vincent; Tournaire, Magali; Girard, Manon; Dumont, Bruno; Bouret, Pauline; Magnetto, Julia; Baghdadli, Amaria; Pellestor, Franck; Geneviève, David

    2015-12-01

    Intellectual disability (ID) is a frequent feature but is highly clinically and genetically heterogeneous. The establishment of the precise diagnosis in patients with ID is challenging due to this heterogeneity but crucial for genetic counseling and appropriate care for the patients. Among the etiologies of patients with ID, apparently balanced de novo rearrangements represent 0.6%. Several mechanisms explain the ID in patients with apparently balanced de novo rearrangement. Among them, disruption of a disease gene at the breakpoint, is frequently evoked. In this context, technologies recently developed are used to characterize precisely such chromosomal rearrangements. Here, we report the case of a boy with ID, facial features and autistic behavior who is carrying a de novo balanced reciprocal translocation t(3;7)(q11.2;q11.22)dn. Using microarray analysis, array painting (AP) technology combined with molecular study, we have identified the interruption of the autism susceptibility candidate 2 gene (AUTS2) and EPH receptor A6 gene (EPHA6). We consider that the disruption of AUTS2 explains the phenotype of the patient; the exact role of EPHA6 in human pathology is not well defined. Based on the observation of recurrent germinal and somatic translocations involving AUTS2 and the molecular environment content, we put forward the hypothesis that the likely chromosomal mechanism responsible for the translocation could be due either to replicative stress or to recombination-based mechanisms.

  8. Description of the phenotypes of 63 heterozygous, homozygous and compound heterozygous patients carrying the Hb Groene Hart [α119(H2)Pro→Ser; HBA1: c.358C>T] variant.

    Science.gov (United States)

    Joly, Philippe; Lacan, Philippe; Garcia, Caroline; Francina, Alain

    2014-01-01

    We here report the phenotypes and genotypes of 63 patients of North African origin, carriers of Hb Groene Hart [Hb GH, α119(H2)Pro → Ser; HBA1: c.358C>T], an α(+)-thalassemia (α(+)-thal) hemoglobin (Hb) variant. Fifty patients were heterozygous, five were homozygous and eight also carried the common -α(3.7) (rightward) deletion in compound heterozygosity. The expression of the α(GH)-globin chain is increased in the following order: heterozygous, compound heterozygous and homozygous. Parallel significant changes of mean corpuscular Hb (MCH) and mean corpuscular volume (MCV) were also observed. Our large cohort of Hb GH carriers could have been obtained by the systematic realization of globin chain separation by reversed phase liquid chromatography (RP-LC) in our routine Hb testing.

  9. Could the local population of the Lower Rhine delta supply the Roman army? Part 2: Modelling the carrying capacity of the delta using archaeological, palaeo-ecological and geomorphological data

    NARCIS (Netherlands)

    Kooistra, L.I.; van Dinter, M.; Dütting, M.K.; van Rijn, P.; Cavallo, C.

    2014-01-01

    In this part two of a diptych of articles, we modelled and quantified the carrying capacity of the landscape and the demand and supply of the Roman army in the western Lower Rhine delta with wood and food in the period A.D.  – . The absolute volumes of the wood and food were calculated (in m

  10. Morphing patient-specific musculoskeletal models

    DEFF Research Database (Denmark)

    Rasmussen, John; Galibarov, Pavel E.; Al-Munajjed, Amir;

    Anatomically realistic musculoskeletal models tend to be very complicated. The current full-body model of the AnyScript Model Repository comprises more than 1000 individually activated muscles and hundreds of bones and joints, and the development of these generic body parts represents an investment...... the generic model differs significantly from the patient in question. The scenario therefore entails two sets of data: (i) a generic musculoskeletal model representing a single (average) individual, and (ii) a set of 3-D medical imaging data, typically in the form of a DICOM file obtained from CT, MRI...... or surface scans. Furthermore, we assume that a set of corresponding anatomical landmarks can be identified in the medical imaging data and on the generic musculoskeletal model. A nonlinear transformation, i.e. a morphing, is created by means of radial basis functions that maps points set (i) to point set...

  11. Methodology to carry out a sensitivity and uncertainty analysis for cross sections using a coupled model Trace-Parcs; Metodologia para realizar un analisis de sensibilidad e incertidumbre para las secciones eficaces usando un modelo acoplado TRACE-PARCS

    Energy Technology Data Exchange (ETDEWEB)

    Reyes F, M. C.; Del Valle G, E. [IPN, Escuela Superior de Fisica y Matematicas, Av. IPN s/n, Col. Lindavista, 07738 Ciudad de Mexico (Mexico); Gomez T, A. M. [ININ, Departamento de Sistemas Nucleares, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico); Sanchez E, V., E-mail: rf.melisa@gmail.com [Karlsruhe Institute of Technology, Institute for Neutron Physics and Reactor Technology, Hermann-von-Helmholtz-Platz 1, D-76344 Eggenstein-Leopoldshafen (Germany)

    2015-09-15

    A methodology was implemented to carry out a sensitivity and uncertainty analysis for cross sections used in a coupled model for Trace/Parcs in a transient of control rod fall of a BWR-5. A model of the reactor core for the neutronic code Parcs was used, in which the assemblies located in the core are described. Thermo-hydraulic model in Trace was a simple model, where only a component type Chan was designed to represent all the core assemblies, which it was within a single vessel and boundary conditions were established. The thermo-hydraulic part was coupled with the neutron part, first for the steady state and then a transient of control rod fall was carried out for the sensitivity and uncertainty analysis. To carry out the analysis of cross sections used in the coupled model Trace/Parcs during the transient, the Probability Density Functions for 22 parameters selected from the total of neutronic parameters that use Parcs were generated, obtaining 100 different cases for the coupled model Trace/Parcs, each one with a database of different cross sections. All these cases were executed with the coupled model, obtaining in consequence 100 different output files for the transient of control rod fall doing emphasis in the nominal power, for which an uncertainty analysis was realized at the same time generate the band of uncertainty. With this analysis is possible to observe the ranges of results of the elected responses varying the selected uncertainty parameters. The sensitivity analysis complements the uncertainty analysis, identifying the parameter or parameters with more influence on the results and thus focuses on these parameters in order to better understand their effects. Beyond the obtained results, because is not a model with real operation data, the importance of this work is to know the application of the methodology to carry out the sensitivity and uncertainty analyses. (Author)

  12. Identification of colorectal cancer patients with tumors carrying the TP53 mutation on the codon 72 proline allele that benefited most from 5-fluorouracil (5-FU based postoperative chemotherapy

    Directory of Open Access Journals (Sweden)

    Tsuchiya Eiju

    2009-12-01

    Full Text Available Abstract Background Although postoperative chemotherapy is widely accepted as the standard modality for Dukes' stage C or earlier stage colorectal cancer (CRC patients, biomarkers to predict those who may benefit from the therapy have not been identified. Previous in vitro and clinical investigations reported that CRC patients with wild-type p53 gene (TP53-tumors benefit from 5-fluorouracil (5-FU based chemotherapy, while those with mutated TP53-tumors do not. However, these studies evaluated the mutation-status of TP53 by immunohistochemistry with or without single-strand conformation polymorphism, and the mutation frequency was different from study to study. In addition, the polymorphic status at p53 codon 72, which results in arginine or proline residues (R72P and is thought to influence the function of the protein significantly, was not examined. Methods To evaluate the significance of the TP53 mutation as a molecular marker to predict the prognosis of CRC patients, especially those who received postoperative chemotherapy, we examined the mutation by direct sequencing from fresh CRC tumors and evaluated the R72P polymorphism of the mutated TP53 by a combined mutant allele- and polymorphic allele-specific polymerase chain reaction (PCR. Results The TP53 mutation occurred in 147 (70% of 211 Japanese CRC tumors. The mutation was observed in 93 (63% tumors on the R72 allele and in 54 (37% tumors on the P72 allele. Although the alterations to TP53 have no prognostic significance for CRC patients overall, we found that Dukes' stage C CRC patients who did not receive postoperative chemotherapy and carried the mutated TP53-R72 showed significantly longer survival times than those with the mutated TP53-P72 when evaluated by overall survival (p = 0.012. Conclusion Using a combined mutant allele- and polymorphic allele-specific PCR, we defined the codon 72 polymorphic status of the TP53 mutated allele in Japanese CRC patients. We raised a possibility

  13. Liposomal Nanoparticles Carrying anti-IL6R Antibody to the Tumour Microenvironment Inhibit Metastasis in Two Molecular Subtypes of Breast Cancer Mouse Models

    Science.gov (United States)

    Guo, Chunlei; Chen, Yanan; Gao, Wenjuan; Chang, Antao; Ye, Yujie; Shen, Wenzhi; Luo, Yunping; Yang, Shengyong; Sun, Peiqing; Xiang, Rong; Li, Na

    2017-01-01

    Tumour microenvironment (TME) contributes significantly towards potentiating the stemness and metastasis properties of cancer cells. IL6-Stat3 is one of the important cell signaling pathways in mediating the communication between tumour and immune cells. Here, we have systematically developed a novel anti-CD44 antibody-mediated liposomal nanoparticle delivery system loaded with anti-IL6R antibody, which could specifically target the TME of CD44+ breast cancer cells in different mouse models for triple negative and luminal breast cancer. This nanoparticle had an enhanced and specific tumour targeting efficacy with dramatic anti-tumour metastasis effects in syngeneic BALB/c mice bearing 4T1 cells as was in the syngeneic MMTV-PyMT mice. It inhibited IL6R-Stat3 signaling and moderated the TME, characterized by the reduced expression of genes encoding Stat3, Sox2, VEGFA, MMP-9 and CD206 in the breast tissues. Furthermore, this nanoparticle reduced the subgroups of Sox2+ and CD206+ cells in the lung metastatic foci, demonstrating its inhibitory effect on the lung metastatic niche for breast cancer stem cells. Taken together, the CD44 targeted liposomal nanoparticles encapsulating anti-IL6R antibody achieved a significant effect to inhibit the metastasis of breast cancer in different molecular subtypes of breast cancer mouse models. Our results shed light on the application of nanoparticle mediated cancer immune-therapy through targeting TME. PMID:28255366

  14. Carrying Capacity:An Overview

    Institute of Scientific and Technical Information of China (English)

    Chen Shaofeng

    2004-01-01

    The concept of carrying capacity is derived from ecology, with widespread contentions of its theoretical connotations and applications in the international academic community, especially the impact of human activities on the environment.Disputes on carrying capacity have been occurring not only among biologists and ecologists, but also among mainstream economists. Based on their efforts,the author makes an attempt to describe its origin,connotations, problems, measurement, and at the same time note the latest international progress in this field.

  15. An empirical model for salt removal percentage in water under the effect of different current intensities of current carrying coil at different flow rates

    Directory of Open Access Journals (Sweden)

    Rameen S. AbdelHady

    2011-10-01

    Full Text Available The magnetic treatment of hard water is an alternative, simple approach by which the hard water that needs to be treated flows through a magnetic field. This field is created by inducing current in a coil wrapped around a pipe. Consequently some of its properties, such as total dissolved salts (TDS, conductivity (Ec and PH change. The primary purpose of hard water treatment is to decrease TDS in the incoming liquid stream. Using performance data from the application of different magnetic field densities on the different flow levels of water, empirical mathematical models were developed relating the salt removal percentage (SRP to operating flow rate and current of the coil. The obtained experimental results showed that the SRP increased with increasing the current at low flow rates (up to 0.75 ml/s.

  16. Expression Analysis of Hairpin RNA Carrying Sugarcane mosaic virus (SCMV) Derived Sequences and Transgenic Resistance Development in a Model Rice Plant

    Science.gov (United States)

    Akbar, Sehrish; Wang, Ming-Bo; Liu, Qing

    2017-01-01

    Developing transgenic resistance in monocotyledonous crops against pathogens remains a challenging area of research. Sugarcane mosaic virus (SCMV) is a serious pathogen of many monocotyledonous crops including sugarcane. The objective of present study was to analyze transgenic expression of hairpin RNA (hpRNA), targeting simultaneously CP (Coat Protein) and Hc-Pro (helper component-proteinase) genes of SCMV, in a model rice plant. Conserved nucleotide sequences, exclusive for DAG (Aspartic acid-Alanine-Glycine) and KITC (Lycine-Isoleucine-Threonine-Cysteine) motifs, derived from SCMV CP and Hc-Pro genes, respectively, were fused together and assembled into the hpRNA cassette under maize ubiquitin promoter to form Ubi-hpCP:Hc-Pro construct. The same CP:Hc-Pro sequence was fused with the β-glucuronidase gene (GUS) at the 3′ end under CaMV 35S promoter to develop 35S-GUS:CP:Hc-Pro served as a target reporter gene construct. When delivered into rice callus tissues by particle bombardment, the Ubi-hpCP:Hc-Pro construct induced strong silencing of 35S-GUS:CP:Hc-Pro. Transgenic rice plants, containing Ubi-hpCP:Hc-Pro construct, expressed high level of 21–24 nt small interfering RNAs, which induced specific suppression against GUS:CP:Hc-Pro delivered by particle bombardment and conferred strong resistance to mechanically inoculated SCMV. It is concluded that fusion hpRNA approach is an affordable method for developing resistance against SCMV in model rice plant and it could confer SCMV resistance when transformed into sugarcane. PMID:28255554

  17. Model construction of nursing service satisfaction in hospitalized tumor patients.

    Science.gov (United States)

    Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved.

  18. Penetrance of HNPCC-related cancers in a retrolective cohort of 12 large Newfoundland families carrying a MSH2 founder mutation: an evaluation using modified segregation models

    Directory of Open Access Journals (Sweden)

    Kopciuk Karen A

    2009-10-01

    Full Text Available Abstract Background Accurate risk (penetrance estimates for associated phenotypes in carriers of a major disease gene are important for genetic counselling of at-risk individuals. Population-specific estimates of penetrance are often needed as well. Families ascertained from high-risk disease clinics provide substantial data to estimate penetrance of a disease gene, but these estimates must be adjusted for possible specific sources of bias. Methods A cohort of 12 independently ascertained HNPCC families harbouring a founder MSH2 mutation was identified from a cancer genetics clinic in St. John's, Newfoundland, Canada. Carrier status was known for 247 family members but phenotype information on up to 85 additional relatives with unknown carrier status was available; using modified segregation models these additional individuals could be included in the analyses. Three HNPCC-related phenotypes were evaluated as age at diagnosis of: any HNPCC cancer (first cancer, colorectal cancer (CRC, and endometrial cancer (EC for females. Results Lifetime (age 70 risk estimates for male and female carriers were similar for developing any HNPCC cancer (Males = 98.2%, 95% Confidence Interval (CI = (93.8%, 99.9%; Females = 92.8%, 95% CI = (82.4%, 99.1% but female carriers experienced substantially reduced lifetime risk for developing CRC compared to male carriers (Females = 38.9%, 95% CI = (24.2%, 62.1%; Males = 84.5%, 95% CI = (67.3%, 91.3%. Female non-carriers had very low lifetime risk for these two outcomes while male non-carriers had lifetime risks intermediate to the female carriers and non-carriers. Female carriers had a lifetime risk of developing EC of 82.4%. Relative risks for developing any HNPCC cancer (carriers relative to non-carriers were substantially greater for females compared to their male counterparts (Females = 54.8, 95%CI = (4.4, 379.8; Males = 9.7, 95% CI = (0.3, 23.8. Relative risks for developing CRC at age 70 were substantially greater

  19. Modeling Serum Creatinine in Septic ICU Patients

    DEFF Research Database (Denmark)

    De Gaetano, Andrea; Cortese, Giuliana; Pedersen, Morten Gram

    2004-01-01

    Serum creatinine is a metabolite assumed to be constantly produced by the normally functioning muscle mass and is a good measure for monitoring daily renal function in the intensive care unit (ICU). High serum creatinine levels or an abnormal departure from normal pre-disease basal levels....... The present work details the structure of a model describing observed creatinine serum concentration (CSC) variations, depending on the time-varying septic insult to renal function in ICU patients, as well as the estimation of its parameters. CSC determinations were routinely obtained from 12 patients...

  20. Watershed water ecological carrying capacity and optimizing regulation model%流域水生态承载力理论与优化调控模型方法

    Institute of Scientific and Technical Information of China (English)

    彭文启

    2013-01-01

    Watershed management is changing from single factor management of environment and re-sources to aquatic ecological protection integrated management. Water resources carrying capacity and water en-vironment carrying capacity have not fully adapted to this situation. Therefore,it is necessary to build a new car-rying capacity theory to solve the current aquatic problems. According to the demands of watershed water ecolog-ical integrity protection management,based on water ecological carrying capacity concept model,water ecologi-cal carrying capacity concept,which reveals its basic connotation of“partition,staging”property and“quanti-ty,quality,order”progressive comprehensive constraint effects,was put forward in this paper. Then the paper analyzed its key optimal regulation variables,and established the water ecological carrying capacity partition coupling concept model using eco-regions as elements. Considering the communication of water flow and water quality among eco-regions,the system dynamics simulation model of Taizi River basin water ecological carrying capacity was established,the water ecological carrying capacity of 8 eco-regions were simulated,and optional regulation schemes of each eco-regions were determined,which can provide a scientific basis for the sustainable development of the watershed.%  流域管理正在从环境及资源的单一要素管理向流域水生态系统综合管理转变,流域水生态承载力是流域水生态系统综合管理的基本理论。针对流域水生态完整性保护管理需求,建立了流域水生态承载力概念模型,提出了流域水生态承载力概念,揭示其“分区、分期”属性和“量、质、序”递进综合约束作用等基本内涵,通过分析其优化调控特性及优化调控关键变量,建立了流域水生态承载力分区耦合概念模型,形成了基于系统动力学方法的流域水生态承载力分区分期耦合模型方法,并以辽河

  1. Collaborative deliberation: a model for patient care.

    Science.gov (United States)

    Elwyn, Glyn; Lloyd, Amy; May, Carl; van der Weijden, Trudy; Stiggelbout, Anne; Edwards, Adrian; Frosch, Dominick L; Rapley, Tim; Barr, Paul; Walsh, Thom; Grande, Stuart W; Montori, Victor; Epstein, Ronald

    2014-11-01

    Existing theoretical work in decision making and behavior change has focused on how individuals arrive at decisions or form intentions. Less attention has been given to theorizing the requirements that might be necessary for individuals to work collaboratively to address difficult decisions, consider new alternatives, or change behaviors. The goal of this work was to develop, as a forerunner to a middle range theory, a conceptual model that considers the process of supporting patients to consider alternative health care options, in collaboration with clinicians, and others. Theory building among researchers with experience and expertise in clinician-patient communication, using an iterative cycle of discussions. We developed a model composed of five inter-related propositions that serve as a foundation for clinical communication processes that honor the ethical principles of respecting individual agency, autonomy, and an empathic approach to practice. We named the model 'collaborative deliberation.' The propositions describe: (1) constructive interpersonal engagement, (2) recognition of alternative actions, (3) comparative learning, (4) preference construction and elicitation, and (5) preference integration. We believe the model underpins multiple suggested approaches to clinical practice that take the form of patient centered care, motivational interviewing, goal setting, action planning, and shared decision making. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Patient-Specific Computational Modeling of Human Phonation

    Science.gov (United States)

    Xue, Qian; Zheng, Xudong; University of Maine Team

    2013-11-01

    Phonation is a common biological process resulted from the complex nonlinear coupling between glottal aerodynamics and vocal fold vibrations. In the past, the simplified symmetric straight geometric models were commonly employed for experimental and computational studies. The shape of larynx lumen and vocal folds are highly three-dimensional indeed and the complex realistic geometry produces profound impacts on both glottal flow and vocal fold vibrations. To elucidate the effect of geometric complexity on voice production and improve the fundamental understanding of human phonation, a full flow-structure interaction simulation is carried out on a patient-specific larynx model. To the best of our knowledge, this is the first patient-specific flow-structure interaction study of human phonation. The simulation results are well compared to the established human data. The effects of realistic geometry on glottal flow and vocal fold dynamics are investigated. It is found that both glottal flow and vocal fold dynamics present a high level of difference from the previous simplified model. This study also paved the important step toward the development of computer model for voice disease diagnosis and surgical planning. The project described was supported by Grant Number ROlDC007125 from the National Institute on Deafness and Other Communication Disorders (NIDCD).

  3. 基于数学模型的物流港口资源承载能力预测%Forecasting of Resource Carrying Capacity of Logistics Terminals Based on Mathematical Model

    Institute of Scientific and Technical Information of China (English)

    陈朝坚

    2014-01-01

    In this paper, we built the mathematical model of the resource carrying capacity of logistics terminals, then comprehensively forecast the transportation resource carrying capacity of the Qinhuangdao logistics terminal to verify the correctness of the mathematical model and presented the scientific planning for the future construction of the terminal.%建立了物流港口资源承载能力的数学模型,对港口交通资源承载力进行了综合预测预警,以河北省秦皇岛物流港口为例,验证了数学模型的正确性,并对秦皇岛港口未来的港口建设提出了科学的规划。

  4. Could the local population of the Lower Rhine delta supply the Roman army? Part 2: Modelling the carrying capacity of the delta using archaeological, palaeo-ecological and geomorphological data

    NARCIS (Netherlands)

    Kooistra, L.I.; van Dinter, M.; Dütting, M.K.; van Rijn, P.; Cavallo, C.

    2014-01-01

    In this part two of a diptych of articles, we modelled and quantified the carrying capacity of the landscape and the demand and supply of the Roman army in the western Lower Rhine delta with wood and food in the period A.D.  – . The absolute volumes of the wood and food were calculated (in m a

  5. Naturalistic Elements in Sister Carrie

    Institute of Scientific and Technical Information of China (English)

    刘艳晖

    2007-01-01

    @@ Theodore Dreiser is considered to be a controversial writer.His first novel.Sister Carrie makes a new way of presenting re-ality.This paper discusses the naturalistic elements from the de-tailed description of the environment in that society.

  6. Whole-Body Muscle MRI in Patients with Hyperkalemic Periodic Paralysis Carrying the SCN4A Mutation T704M: Evidence for Chronic Progressive Myopathy with Selective Muscle Involvement.

    Science.gov (United States)

    Lee, Young Han; Lee, Hyung Soo; Lee, Hyo Eun; Hahn, Seok; Nam, Tai Seung; Shin, Ha Young; Choi, Young Chul; Kim, Seung Min

    2015-10-01

    Hyperkalemic periodic paralysis (hyperKPP) is a muscle sodium-ion channelopathy characterized by recurrent paralytic attacks. A proportion of affected individuals develop fixed or chronic progressive weakness that results in significant disability. However, little is known about the pathology of hyperKPP-induced fixed weakness, including the pattern of muscle involvement. The aim of this study was to characterize the patterns of muscle involvement in hyperKPP by whole-body magnetic resonance imaging (MRI). We performed whole-body muscle MRI in seven hyperKPP patients carrying the T704M mutation in the SCN4A skeletal sodium-channel gene. Muscle fat infiltration, suggestive of chronic progressive myopathy, was analyzed qualitatively using a grading system and was quantified by the two-point Dixon technique. Whole-body muscle MRI analysis revealed muscle atrophy and fatty infiltration in hyperKPP patients, especially in older individuals. Muscle involvement followed a selective pattern, primarily affecting the posterior compartment of the lower leg and anterior thigh muscles. The muscle fat fraction increased with patient age in the anterior thigh (r=0.669, p=0.009), in the deep posterior compartment of the lower leg (r=0.617, p=0.019), and in the superficial posterior compartment of the lower leg (r=0.777, p=0.001). Our whole-body muscle MRI findings provide evidence for chronic progressive myopathy in hyperKPP patients. The reported data suggest that a selective pattern of muscle involvement-affecting the posterior compartment of the lower leg and the anterior thigh-is characteristic of chronic progressive myopathy in hyperKPP.

  7. α-Mangostin extracted from the pericarp of the mangosteen (Garcinia mangostana Linn reduces tumor growth and lymph node metastasis in an immunocompetent xenograft model of metastatic mammary cancer carrying a p53 mutation

    Directory of Open Access Journals (Sweden)

    Okuno Yasushi

    2011-06-01

    -mangostin significantly decreased the levels of phospho-Akt-threonine 308 (Thr308, but not serine 473 (Ser473, in both mammary carcinoma cell cultures and mammary carcinoma tissues in vivo. Conclusions Since lymph node involvement is the most important prognostic factor in breast cancer patients, the antimetastatic activity of α-mangostin as detected in mammary cancers carrying a p53 mutation in the present study may have specific clinical applications. In addition, α-mangostin may have chemopreventive benefits and/or prove useful as an adjuvant therapy, or as a complementary alternative medicine in the treatment of breast cancer.

  8. About rats and jackfruit trees: modeling the carrying capacity of a Brazilian Atlantic Forest spiny-rat Trinomys dimidiatus (Günther, 1877) - Rodentia, Echimyidae - population with varying jackfruit tree (Artocarpus heterophyllus L.) abundances.

    Science.gov (United States)

    Mello, J H F; Moulton, T P; Raíces, D S L; Bergallo, H G

    2015-01-01

    We carried out a six-year study aimed at evaluating if and how a Brazilian Atlantic Forest small mammal community responded to the presence of the invasive exotic species Artocarpus heterophyllus, the jackfruit tree. In the surroundings of Vila Dois Rios, Ilha Grande, RJ, 18 grids were established, 10 where the jackfruit tree was present and eight were it was absent. Previous results indicated that the composition and abundance of this small mammal community were altered by the presence and density of A. heterophyllus. One observed effect was the increased population size of the spiny-rat Trinomys dimidiatus within the grids where the jackfruit trees were present. Therefore we decided to create a mathematical model for this species, based on the Verhulst-Pearl logistic equation. Our objectives were i) to calculate the carrying capacity K based on real data of the involved species and the environment; ii) propose and evaluate a mathematical model to estimate the population size of T. dimidiatus based on the monthly seed production of jackfruit tree, Artocarpus heterophyllus and iii) determinate the minimum jackfruit tree seed production to maintain at least two T. dimidiatus individuals in one study grid. Our results indicated that the predicted values by the model for the carrying capacity K were significantly correlated with real data. The best fit was found considering 20~35% energy transfer efficiency between trophic levels. Within the scope of assumed premises, our model showed itself to be an adequate simulator for Trinomys dimidiatus populations where the invasive jackfruit tree is present.

  9. About rats and jackfruit trees: modeling the carrying capacity of a Brazilian Atlantic Forest spiny-rat Trinomys dimidiatus (Günther, 1877 – Rodentia, Echimyidae – population with varying jackfruit tree (Artocarpus heterophyllus L. abundances

    Directory of Open Access Journals (Sweden)

    JHF Mello

    Full Text Available We carried out a six-year study aimed at evaluating if and how a Brazilian Atlantic Forest small mammal community responded to the presence of the invasive exotic species Artocarpus heterophyllus, the jackfruit tree. In the surroundings of Vila Dois Rios, Ilha Grande, RJ, 18 grids were established, 10 where the jackfruit tree was present and eight were it was absent. Previous results indicated that the composition and abundance of this small mammal community were altered by the presence and density of A. heterophyllus. One observed effect was the increased population size of the spiny-rat Trinomys dimidiatus within the grids where the jackfruit trees were present. Therefore we decided to create a mathematical model for this species, based on the Verhulst-Pearl logistic equation. Our objectives were i to calculate the carrying capacity K based on real data of the involved species and the environment; ii propose and evaluate a mathematical model to estimate the population size of T. dimidiatus based on the monthly seed production of jackfruit tree, Artocarpus heterophyllus and iii determinate the minimum jackfruit tree seed production to maintain at least two T. dimidiatus individuals in one study grid. Our results indicated that the predicted values by the model for the carrying capacity K were significantly correlated with real data. The best fit was found considering 20~35% energy transfer efficiency between trophic levels. Within the scope of assumed premises, our model showed itself to be an adequate simulator for Trinomys dimidiatus populations where the invasive jackfruit tree is present.

  10. Personalized Predictive Modeling and Risk Factor Identification using Patient Similarity.

    Science.gov (United States)

    Ng, Kenney; Sun, Jimeng; Hu, Jianying; Wang, Fei

    2015-01-01

    Personalized predictive models are customized for an individual patient and trained using information from similar patients. Compared to global models trained on all patients, they have the potential to produce more accurate risk scores and capture more relevant risk factors for individual patients. This paper presents an approach for building personalized predictive models and generating personalized risk factor profiles. A locally supervised metric learning (LSML) similarity measure is trained for diabetes onset and used to find clinically similar patients. Personalized risk profiles are created by analyzing the parameters of the trained personalized logistic regression models. A 15,000 patient data set, derived from electronic health records, is used to evaluate the approach. The predictive results show that the personalized models can outperform the global model. Cluster analysis of the risk profiles show groups of patients with similar risk factors, differences in the top risk factors for different groups of patients and differences between the individual and global risk factors.

  11. 基于RBF的指标规范值的水资源承载力评价模型%Evaluation Model of Carrying Capacity of Water Resources Represented with Normalized Indices Values Based on Radial Basis Function Neural Network

    Institute of Scientific and Technical Information of China (English)

    臧蕾; 刘伟; 李祚泳

    2012-01-01

    [Objective ] The aim was to study the assessment model of carrying capacity of water resources represented with normalized indices values based on radial basis function network ( RBF). [ Method] On the basis of the normalized transformation for indices, the basis function of model was universal for various indices and made representative calculation greatly simplified, as mean as normalized values of standards at all levels as the normalized values of each component of center vector for the basis functions in hidden nodes. [ Result] The RBF model optimized weight values by monkey king algorithm was applied to assess the carrying capacities of water resources in three districts of Changwu County of Shaanxi Province, the evaluation results were basically consistent with that of fuzzy assessment method. [ Conclusion] RBF model is simple and practical, and has universality and generality.%[目的]研究基于指标规范值的区域水资源承载力评价的径向基函数网络模型(RBF).[方法]在对指标进行规范变换的基础上,将指标各级标准规范值的平均值作为RBF的隐层节点基函数中心矢量各分量的规范值,因而基函数对各指标具有普适性,使基函数的表示和计算大为简化.[结果]将猴王算法优化网络权值得到的RBF模型应用于陕西省长武县3个区域水资源承载力的评价,其评价结果与模糊综合评价结果基本一致.[结论]RBF模型具有简单、实用的特点,具有普适性和通用性.

  12. Estoma & câncer retal: revisão de 195 estomas realizados em 380 pacientes portadores de câncer retal Stoma and rectal cancer: review of 195 stomas carried out in 380 patients with rectal cancer

    Directory of Open Access Journals (Sweden)

    Geraldo Magela Gomes da Cruz

    2008-06-01

    estomas executados, assim distribuídas: oito complicações em 146 colostomias terminais (5,5%, uma complicação dentre as 30 colostomias em alça (3,3%, três complicação nas três colostomias duplas (100,0%, duas complicações em 12 ileostomias am alça (16,7% e nenhuma complicação entre as quatro ileostomias terminais. Estenose e prolapso foram as complicações mais comuns (quatro casos de cada.The aim of this report is to analyze 380 patients with rectal cancer with special concern to the 195 stomas carried out with particular reference to temporary and definitive stomas as well as several surgical techniques used and their indications and complications. Three hundred seventy three out of 380 patients underwent surgery (98.2% being 373 tumors resected (91.8%. As far as surgical technique is concerned abdominal rectosigmoidectomy was carried out in 172 of 338 patients who had their tumors removed, being 133 with hand anastomoses (35.0 and 39 with stapled anastomoses (10.3%. Miles procedure was made in 135 (35.5%, local excision in 27 (7.1% and proctocolectomy and end ileostomy in four patients (1.0%. One hundred ninety five of 373 patients who underwent surgical treatment had stomas created in their abdomen (52.3%, being 174 definitive (46.6% and 21 temporary (5.7%. So 174 of the 195 stomas carried out were definitive (89.2% and 21 temporary (10.8%. One hundred and forty six of 195 stomas were end colostomies (39.1%, four end ileostomies (1.1%, 30 loop colostomies (8.0%, three double colostomies (0.8% and 12 loop ileostomies (3.2%. As far as 21 temporary stomas performed in 172 cases of local excision and abdominal rectosigmoidectomy (12.2% are concerned nine were loop colostomy (5.2% and 12 loop ileostomy (7.0%. Sixteen of 21 temporary stomas were made in 133 cases of hand anastomoses, being eight loop colostomies (6.0% and eight loop ileostomies (6.0%; and five in 39 cases of stapled anastomoses, being one loop colostomy (2.6% and four loop ileostomies (10

  13. Prevalence of ST1193 clone and IncI1/ST16 plasmid in E-coli isolates carrying blaCTX-M-55 gene from urinary tract infections patients in China.

    Science.gov (United States)

    Xia, Liang; Liu, Yang; Xia, Shu; Kudinha, Timothy; Xiao, Shu-Nian; Zhong, Nan-Shan; Ren, Guo-Sheng; Zhuo, Chao

    2017-03-24

    To study molecular epidemiology of CTX-M-55-carrying Escherichia coli isolates from urinary tract infections (UTIs) in China. 111 blaCTX-M-55-positive E.coli isolates from UTIs patients in China were studied. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were used to analyze the homologies among the strains. Conjugation experiments, S1nuclease PFGE and PCR analysis were performed to characterize plasmids harboring blaCTX-M-55 and their genetic environment. 111 isolates were clustered into 86 individual pulsotypes and three clusters by PFGE. Fifty-five (49.5%) of the isolates belonged to 8 STs. Most of the ST1193 isolates belonged to one PFGE cluster. Transconjugants (n = 45) derived from randomly selected blaCTX-M-55 donors (n = 58), were found to contain a single 90-kb conjugative plasmid, which mainly belonged to the IncI1 groups (34, 76%). Among the IncI1 plasmids, the blaCTX-M-55/IncI1/ST16 predominated (23/34, 68%). The blaTEM-1 and aac (3')-II genes were frequently detected on the IncI1 plasmids, and the insertion of ISEcp1 or IS26 was observed at the 48 bp or 45 bp upstream of the start codon of blaCTX-M-55 gene. The dissemination of blaCTX-M-55 gene among E. coli UTI isolates, appeared to be due to both the major clonal lineage of ST1193 and the horizontal transfer of epidemic plasmid IncI1/ST16.

  14. Prevalence of ST1193 clone and IncI1/ST16 plasmid in E-coli isolates carrying blaCTX-M-55 gene from urinary tract infections patients in China

    Science.gov (United States)

    Xia, Liang; Liu, Yang; Xia, Shu; Kudinha, Timothy; Xiao, Shu-nian; Zhong, Nan-shan; Ren, Guo-sheng; Zhuo, Chao

    2017-01-01

    To study molecular epidemiology of CTX-M-55-carrying Escherichia coli isolates from urinary tract infections (UTIs) in China. 111 blaCTX-M-55-positive E.coli isolates from UTIs patients in China were studied. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were used to analyze the homologies among the strains. Conjugation experiments, S1nuclease PFGE and PCR analysis were performed to characterize plasmids harboring blaCTX-M-55 and their genetic environment. 111 isolates were clustered into 86 individual pulsotypes and three clusters by PFGE. Fifty-five (49.5%) of the isolates belonged to 8 STs. Most of the ST1193 isolates belonged to one PFGE cluster. Transconjugants (n = 45) derived from randomly selected blaCTX-M-55 donors (n = 58), were found to contain a single 90-kb conjugative plasmid, which mainly belonged to the IncI1 groups (34, 76%). Among the IncI1 plasmids, the blaCTX-M-55/IncI1/ST16 predominated (23/34, 68%). The blaTEM-1 and aac (3′)-II genes were frequently detected on the IncI1 plasmids, and the insertion of ISEcp1 or IS26 was observed at the 48 bp or 45 bp upstream of the start codon of blaCTX-M-55 gene. The dissemination of blaCTX-M-55 gene among E. coli UTI isolates, appeared to be due to both the major clonal lineage of ST1193 and the horizontal transfer of epidemic plasmid IncI1/ST16. PMID:28338012

  15. Study of Social Rehabilitation Carried out on Patients with Chronic Schizophrenia%对慢性精神分裂症患者进行社会功能训练的研究

    Institute of Scientific and Technical Information of China (English)

    吴燕芳

    2014-01-01

    Objective:To study the training of social rehabilitation carried out on the patients with chronic schizo-phrenia to make them restore family,career and social rehabilitation as soon as possible to return to society. Methods:100 cases of the patients with chronic schizophrenia were randomly divided into two groups(50 of the observation group and 50 of the control group)from January 2011 to December 2012 in our hospital. Besides the normal nursing and medi-cation as well as the control group,the observation group was adopted the training of social rehabilitation. SANS and NOSIE were respectively assessed and analyzed before the research and after 12 weeks. Results:After12-week training of social rehabilitation,SANS of the observation group was improved greater than that of the control group. There was a statistically significant difference( P<0 . 05 ). NOSIE and total positive factors of the hospitalized patients were increas-ing in the observation group,compared to the control group and there was a statistically significant difference( P<0. 05). The total negative factors were remarkably decreasing. There was a statistically significant difference(P<0 . 05 ). Conclusion:The training of social rehabilitation can improve the living quality and develop the ability of social rehabilitation for the patients with chronic schizophrenia,and furthermore it's important for them to improve social func-tion,reduce mental disability and promote the comprehensive rehabilitation.%目的:对慢性精神分裂症患者进行社会功能训练,使其最大程度地恢复家庭、职业及社会功能以重返社会。方法:将山西省太原精神病医院2011年~2012年住院的100例精神分裂症患者随机分为研究组50例和对照组50例。两组患者均给予药物治疗及常规护理,在此基础上研究组给予社会功能训练,与研究前及研究12周末采取阴性症状评定量表( SANS)及护士用住院患者观察量表( NOSIE)进行评

  16. Patient truthfulness: a test of models of the physician-patient relationship.

    Science.gov (United States)

    Vanderpool, H Y; Weiss, G B

    1984-11-01

    Little attention has been given in medical ethics literature to issues relating to the truthfulness of patients. Beginning with an actual medical case, this paper first explores truth-telling by doctors and patients as related to two prominent models of the physician-patient relationship. Utilizing this discussion and the literature on the truthfulness and accuracy of the information patients convey to doctors, these models are then critically assessed. It is argued that the patient agency (patient autonomy or contractual) model is inherently and seriously flawed in numerous circumstances, even those involving informed and competent adult patients.

  17. Examining the Resilience of Crop Production, Livestock Carrying Capacity, and Woodland Density in a Rural Zimbabwean Socio-Ecological System Using Agent-Based Models Representing Human Management Decisions

    Science.gov (United States)

    Eitzel Solera, M. V.; Neves, K.; Veski, A.; Solera, J.; Omoju, O. E.; Mawere Ndlovu, A.; Wilson, K.

    2016-12-01

    As climate change increases the pressures on arid ecosystems by changing timing and amount of rainfall, understanding the ways in which human management choices affect the resilience of these systems becomes key to their sustainability. On marginal farmland in Mazvihwa, Midlands Province, the historical carrying capacity of livestock has been consistently surprisingly high. We explore this phenomenon by building an agent-based model in NetLogo from a wealth of long-term data generated by the community-based participatory research team of The Muonde Trust, a Zimbabwean non-governmental organization. We combine the accumulated results of 35 years of indigenous and local knowledge with national datasets such as rainfall records. What factors keep the carrying capacity high? What management choices can maintain crops, livestock, and woodland at levels necessary for the community's survival? How do these choices affect long-term sustainability, and does increasing resilience at one scale reduce resilience at another scale? We use our agent-based model to explore the feedbacks between crops, livestock, and woodland and the impacts of various human choices as well as temporal and spatial ecological variation. By testing different scenarios, we disentangle the complex interactions between these components. We find that some factors out of the community's control can strongly affect the sustainability of the system through times of drought, and that supplementary feed may maintain livestock potentially at the expense of other resources. The challenges to resilience encountered by the farmers in Mazvihwa are not unique - many indigenous and rural people face drought and the legacies of colonialism, which contribute to lowered resilience to external challenges such as climate change, epidemics, and political instability. Using the agent-based model as a tool for synthesis and exploration initiates discussion about resilience-enhancing management choices for Mazvihwa's farmer-researchers.

  18. Analysis of survival in breast cancer patients by using different parametric models

    Science.gov (United States)

    Enera Amran, Syahila; Asrul Afendi Abdullah, M.; Kek, Sie Long; Afiqah Muhamad Jamil, Siti

    2017-09-01

    In biomedical applications or clinical trials, right censoring was often arising when studying the time to event data. In this case, some individuals are still alive at the end of the study or lost to follow up at a certain time. It is an important issue to handle the censoring data in order to prevent any bias information in the analysis. Therefore, this study was carried out to analyze the right censoring data with three different parametric models; exponential model, Weibull model and log-logistic models. Data of breast cancer patients from Hospital Sultan Ismail, Johor Bahru from 30 December 2008 until 15 February 2017 was used in this study to illustrate the right censoring data. Besides, the covariates included in this study are the time of breast cancer infection patients survive t, age of each patients X1 and treatment given to the patients X2 . In order to determine the best parametric models in analysing survival of breast cancer patients, the performance of each model was compare based on Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC) and log-likelihood value using statistical software R. When analysing the breast cancer data, all three distributions were shown consistency of data with the line graph of cumulative hazard function resembles a straight line going through the origin. As the result, log-logistic model was the best fitted parametric model compared with exponential and Weibull model since it has the smallest value in AIC and BIC, also the biggest value in log-likelihood.

  19. Woman Carries on Traditional Arts

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    THE members of the International Olympic Bidding Committee in Monte Carlo were amazed at Lang Zhili’s skill in dough modelling. That was in 1993, and the Chinese folk artist was showing her skill to the Committee members. Holding the dough figures that Lang gave them as presents, they could hardly believe that a simple piece of dough could be made into a peace dove so real it appeared ready to fly away. There was also a lovely rabbit, a Chinese boy with a football under his arm, the God of Longevity, the Buddha Maitreya... all looked completely lifelike.

  20. 基于熵权法及灰色关联模型的水资源承载力研究%Research on carrying capacity of water resources based on entropy-weight and grey-correlation model

    Institute of Scientific and Technical Information of China (English)

    朱玲燕; 苏维词

    2014-01-01

    The evaluation of carrying capacity of water resources is an important mean to judge whether the water resources of a city is safe.Taking Quzhou city as the research object , the paper chose the main indexes of carrying capacity evaluation of water resources by grey correlation model.It calculated the total value of water resources carrying capacity and the weight by use of entropy-weight method. Results indi-cate that①the weights of sewage treatment rate and water consumption per ten thousand yuan GDP are 0.1719 and 0.1261 respectively,which are the main indexes of water resources carrying capacity evalua-tion.②The total value of water resources of Quzhou had been raising gradually from 2004 to 2011 .In 2010, the value reached the highest which is about that of 1.23 times in 2004.The paper analyzed the status of water resources in Quzhou and propsed some suggestion for the sustainable utilization of water re-sources.%水资源承载力评价是判断一个城市水资源是否安全的重要手段。本文以衢州市为研究对象,通过应用灰色关联模型选取反映水资源承载力的主要指标,并利用熵权法计算指标权重和水资源承载力综合得分。计算结果表明:①衢州市水资源承载力主要影响指标污水处理率、万元GDP耗水量的权重分别是0.1719,0.1261。②2004-2011年,衢州市水资源承载力综合得分呈上升趋势,特别是2010年达到最高值,约为2004年的1.23倍。本文通过分析衢州市水资源利用状况,提出可持续利用水资源的建议。

  1. 基于RBF的指标规范值的水资源承载力评价模型(英文)%Evaluation Model of Carrying Capacity of Water Resources Based on Standardized Indices of Radial Basis Function

    Institute of Scientific and Technical Information of China (English)

    臧蕾; 李祚泳; 刘伟

    2012-01-01

    [目的]研究基于指标规范值的区域水资源承载力评价的径向基函数网络模型(RBF)。[方法]在对指标进行规范变换的基础上,将指标各级标准规范值的平均值作为RBF的隐层节点基函数中心矢量各分量的规范值,因而基函数对各指标具有普适性,使基函数的表示和计算大为简化。[结果]将猴王算法优化网络权值得到的RBF模型应用于陕西省长武县3个区域水资源承载力的评价,其评价结果与模糊综合评价结果基本一致。[结论]RBF模型具有简单、实用的特点,具有普适性和通用性。%[Objective] The aim was to study on RBF model about evaluation on carrying capacity of water resources based on standardized indices. [Method] The indices were transformed and the averages of standard values in different levels were taken as the standardized values of components of central vectors for basic functions of RBF hidden nodes. Hence, the basic functions are suitable for most indices, simplifying expression and calculation of basic functions. [Result] RBF models concluded through Monkey-king Genetic Algorithm with weights optimization are used in evaluation on water carrying capacity in three districts in Changwu County in Shaanxi Province, which were in consistent with that through fuzzy evaluation. [Conclusion] RBF, simple and practical, is universal and popular.

  2. Incorporación de la cobertura de escape en un modelo de capacidad de carga para venado de cola blanca Incorporation of escape cover in a model to estimate carrying capacity for white-tailed deer

    Directory of Open Access Journals (Sweden)

    FX Plata

    2013-01-01

    Full Text Available Los objetivos de este trabajo fueron evaluar la incorporación de la cobertura de escape en un modelo de capacidad de carga (K de venado cola banca, evaluar el modelo por análisis de sensibilidad y comparar la estimación de la K con el modelo versus un modelo basado en disponibilidad de nutrientes. El trabajo se desarrolló en la localidad de Santa Cruz Nuevo, Puebla, México, en un área de 50 km², donde se establecieron 13 transectos de 800 m de longitud por 6 de ancho y se colectó información para establecer la relación entre la cobertura de escape y la presencia de indicios de venado mediante regresión lineal. Dicha relación se incorporó en un modelo de estimación de K, después de lo cual se realizó un análisis de sensibilidad del mismo. Los indicios animales se observaron principalmente en las áreas con una cobertura de escape mayor al 59% y se distribuyeron en una forma cuadrática hasta llegar al 100%. El análisis de sensibilidad mostró que la cobertura de escape y la vegetación arbustiva fueron los principales componentes para aumentar la capacidad de carga, mientras que el peso vivo del venado para disminuirla.The objective of this study was to establish the incorporation of escape cover in a carrying capacity (K model for white-tailed deer (Odocoileus virginianus. The study was carried out in Santa Cruz Nuevo, Puebla, Mexico in an area of 50 Km². The information was gathered through 13 transects of 800 by six m. The information served to establish the relationship between the escape cover and the faecal pellets of deer using a linear regression analysis. The relationship was included in a model for estimation of K, then a sensibility analysis was conducted. Faecal pellets were found in areas with an escape cover bigger than 59% and they were distributed in a cubic arrangement until reaching the 100%. The sensibility analysis showed that the escape cover and the brush vegetation were the main components to increase the

  3. Model construction of nursing service satisfaction in hospitalized tumor patients

    OpenAIRE

    Chen, Yongyi; LIU, JINGSHI; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients’ expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient s...

  4. Infections That Pets Carry (For Parents)

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Infections That Pets Carry KidsHealth > For Parents > Infections That Pets Carry ... how to protect your family from infections. How Pets Spread Infections Like people, all animals carry germs . ...

  5. HIV/HCV双重感染者抗HCV治疗时机的探讨%Best Time of Carrying on Anti-HCV Treatment in Patients Coinfected with HIV/HCV

    Institute of Scientific and Technical Information of China (English)

    蒋忠胜; 温小凤; 李敏基; 张鹏; 胡家光; 陈念; 柯柳; 覃川

    2012-01-01

    目的 探讨HIV/HCV双重感染者抗HCV治疗的时机.方法 根据基线CD+4 T淋巴细胞计数将HIV/HCV双重感染者分为A、B、C 3组,A组19例(CD+4 T淋巴细胞计数>350个/μl)采用聚乙二醇干扰素α-2a(PEG-IFNα-2a)135或180 μg皮下注射,1次/周,利巴韦林900~1 200 mg口服,1次/d,48周为1个疗程;B组14例(CD+4 T淋巴细胞计数200~350个/μl)先给予高效抗反转录病毒治疗(HAART)治疗8周,再采用A组相同的方案治疗;C组30例(CD+4 T淋巴细胞计数<200个/μl)先给予HAART,复查CD+4 T淋巴细胞计数>200个/μl并持续8周以上再采用A组相同方案治疗.分别在基线及治疗后12周、24周、48周、72周复查患者丙型肝炎病毒RNA(HCV-RNA)和CD+4 T淋巴细胞计数.结果 3组患者中早期病毒学应答(EVR)29例(46.03%),持续病毒学应答(SVR) 28例(44.44%).A+B组的EVR(69.70%)和SVR(66.67%)均高于C组(EVR为20.00%、SVR为20.00%).结论 CD+4 T淋巴细胞计数>200个/μl是HIV/HCV双重感染者抗HCV治疗的最佳时机,其疗效和单纯丙肝患者相近,但CD+4 T淋巴细胞计数<200个/μl者疗效较差.%Objective To discuss the best time of carrying on antiviral therapy against hepatitis C virus ( HCV ) in patients coinfected with HIV and HCV. Methods According to the CD/ T lymphocytes count, we divided the patients enrolled into three groups: Group A ( n = 19 ) whose CD/ T lymphocytes count was above 350/μl, Group B ( n = 14 ) whose CD/ T lymphocytes count was between 200/ μl and 350/μl and Group C ( n = 30 ) whose CD/ T lymphocytes was under 200/μl. Group A was administered pegylated interferon a -2a 135 or 180 μg/week, subcutaneous injection, plus ribavirin 900 ~ 1 200 mg/d, oral, course of treatment with 48 weeks. Group B received the same therapy program as group A after 8 weeks of HAART. For group C, HAART was given firstly and then the same therapy program as group A was performed after CD/ T lymphocytes reached 200/μl and lasted for 2 or more

  6. Identifying abnormal connectivity in patients using Dynamic Causal Modelling of fMRI responses.

    Directory of Open Access Journals (Sweden)

    Mohamed L Seghier

    2010-08-01

    Full Text Available Functional imaging studies of brain damaged patients offer a unique opportunity to understand how sensori-motor and cognitive tasks can be carried out when parts of the neural system that support normal performance are no longer available. In addition to knowing which regions a patient activates, we also need to know how these regions interact with one another, and how these inter-regional interactions deviate from normal. Dynamic Causal Modelling (DCM offers the opportunity to assess task-dependent interactions within a set of regions. Here we review its use in patients when the question of interest concerns the characterisation of abnormal connectivity for a given pathology. We describe the currently available implementations of DCM for fMRI responses, varying from the deterministic bilinear models with one-state equation to the stochastic nonlinear models with two-state equations. We also highlight the importance of the new Bayesian model selection and averaging tools that allow different plausible models to be compared at the single subject and group level. These procedures allow inferences to be made at different levels of model selection, from features (model families to connectivity parameters. Following a critical review of previous DCM studies that investigated abnormal connectivity we propose a systematic procedure that will ensure more flexibility and efficiency when using DCM in patients. Finally, some practical and methodological issues crucial for interpreting or generalising DCM findings in patients are discussed.

  7. Modelagem de redes logísticas com custos de inventário calculados a partir da cobertura de estoque Logistic networks modeling with inventory carrying costs calculated using inventory turnover

    Directory of Open Access Journals (Sweden)

    Ricardo Hamad

    2011-01-01

    Full Text Available A consideração dos custos de inventário tem se tornado cada vez mais importante na análise dos trade-offs e na tomada de decisões sobre redes logísticas. O artigo propõe uma metodologia para tratamento do custo de inventário a partir da cobertura de estoque esperada em cada instalação, incorporada na modelagem matemática da localização de fábricas e/ou centros de distribuição em redes logísticas com vários elos, representando uma nova versão do modelo apresentado em Hamad e Gualda (2008. As principais contribuições desta metodologia em relação a outros métodos encontrados na literatura são a facilidade de aplicação do método, a inclusão de restrições ligadas à capacidade de armazenagem e a consideração do custo total de inventário, e não apenas do custo relacionado aos produtos modelados.Inventory carrying cost has become very important in the analysis of the trade-offs and an important component to be considered when taking decisions about a logistic network. This paper proposes a methodology incorporated in a multi-echelon sourcing decision model, to be considered as a new version of the model presented in Hamad, Gualda (2008. It treats the carrying costs using the inventory Days-on-hand estimate in each echelon of the chain (plants and/or Distribution Centers. The main contributions of this methodology compared to other options found in the literature are the simplicity of its application, the consideration of all inventory costs (not only the ones related to the products being modeled and, also, the inclusion of constraints related to warehousing capacity.

  8. A patient-centered care ethics analysis model for rehabilitation.

    Science.gov (United States)

    Hunt, Matthew R; Ells, Carolyn

    2013-09-01

    There exists a paucity of ethics resources tailored to rehabilitation. To help fill this ethics resource gap, the authors developed an ethics analysis model specifically for use in rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a process model to guide careful moral reasoning for particularly complex or challenging matters in rehabilitation. The Patient-Centered Care Ethics Analysis Model for Rehabilitation was developed over several iterations, with feedback at different stages from rehabilitation professionals and bioethics experts. Development of the model was explicitly informed by the theoretical grounding of patient-centered care and the context of rehabilitation, including the International Classification of Functioning, Disability and Health. Being patient centered, the model encourages (1) shared control of consultations, decisions about interventions, and management of the health problems with the patient and (2) understanding the patient as a whole person who has individual preferences situated within social contexts. Although the major process headings of the Patient-Centered Care Ethics Analysis Model for Rehabilitation resemble typical ethical decision-making and problem-solving models, the probes under those headings direct attention to considerations relevant to rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a suitable tool for rehabilitation professionals to use (in real time, for retrospective review, and for training purposes) to help arrive at ethical outcomes.

  9. A Brief Analysis of Sister Carrie's Character

    Science.gov (United States)

    Yu, Hanying

    2010-01-01

    Carrie is always dreaming while the rocking chair is rocking again and again, this is the deep impression on us after we read "Sister Carrie" which is the first novel of Theodore Dreiser. In this novel the protagonist Sister Carrie is a controversial person. This paper tries to analyze the character of Sister Carrie in order to find out…

  10. Queueing network model for obstetric patient flow in a hospital.

    Science.gov (United States)

    Takagi, Hideaki; Kanai, Yuta; Misue, Kazuo

    2016-03-03

    A queueing network is used to model the flow of patients in a hospital using the observed admission rate of patients and the histogram for the length of stay for patients in each ward. A complete log of orders for every movement of all patients from room to room covering two years was provided to us by the Medical Information Department of the University of Tsukuba Hospital in Japan. We focused on obstetric patients, who are generally hospitalized at random times throughout the year, and we analyzed the patient flow probabilistically. On admission, each obstetric patient is assigned to a bed in one of the two wards: one for normal delivery and the other for high-risk delivery. Then, the patient may be transferred between the two wards before discharge. We confirm Little's law of queueing theory for the patient flow in each ward. Next, we propose a new network model of M/G/ ∞ and M/M/ m queues to represent the flow of these patients, which is used to predict the probability distribution for the number of patients staying in each ward at the nightly census time. Although our model is a very rough and simplistic approximation of the real patient flow, the predicted probability distribution shows good agreement with the observed data. The proposed method can be used for capacity planning of hospital wards to predict future patient load in each ward.

  11. Analysis of circumferential and longitudinal left ventricular systolic function in patients with non-ischemic chronic heart failure and preserved ejection fraction (from the CARRY-IN-HFpEF study).

    Science.gov (United States)

    Cioffi, Giovanni; Senni, Michele; Tarantini, Luigi; Faggiano, Pompilio; Rossi, Andrea; Stefenelli, Carlo; Russo, Tiziano Edoardo; Alessandro, Selmi; Furlanello, Francesco; de Simone, Giovanni

    2012-02-01

    Heart failure with preserved left ventricular ejection fraction (HFpEF) is implicitly attributed to diastolic dysfunction, often recognized in elderly patients with hypertension, diabetes, and renal dysfunction. In these patients, left ventricular circumferential and longitudinal shortening is often impaired despite normal ejection fraction. The aim of this prospective study was to analyze circumferential and longitudinal shortening and their relations in patients with nonischemic HFpEF. Stress-corrected midwall shortening (sc-MS) and mitral annular peak systolic velocity (S') were measured in 60 patients (mean age 73 ± 13 years) with chronic nonischemic HFpEF in stable New York Heart Association functional class II or III and compared to the values in 120 healthy controls and 120 patients with hypertension without HFpEF. Sc-MS was classified as low if HFpEF, 27% of patients with hypertension, and 2% of controls; isolated low S' was detected in 11% of patients with HFpEF, 7% of patients with hypertension, and 5% of controls; and combined low sc-MS and low S' was detected in 26% of patients with HFpEF, 9% of patients with hypertension, and 5% of controls (HFpEF vs others, all p values HFpEF. The relation between sc-MS and S' was nonlinear (cubic). Changes in S' within normal values corresponded to negligible variations in sc-MS, whereas the progressive decrease below 8.5 cm/s was associated with substantial decrease in sc-MS. In conclusion, circumferential and/or longitudinal systolic dysfunction is present in most patients with HFpEF. Circumferential shortening normalized by wall stress identifies more patients with concealed left ventricular systolic dysfunction than longitudinal shortening.

  12. Effect of the patient-to-patient communication model on dysphagia caused by total laryngectomy.

    Science.gov (United States)

    Tian, L; An, R; Zhang, J; Sun, Y; Zhao, R; Liu, M

    2017-03-01

    The study aimed to evaluate the effect of a patient-to-patient communication model on dysphagia in laryngeal cancer patients after total laryngectomy. Sixty-five patients who had undergone total laryngectomy were randomly divided into three groups: a routine communication group, a patient communication group (that received the patient-to-patient communication model) and a physician communication group. Questionnaires were used to compare quality of life and swallowing problems among all patient groups. The main factors causing dysphagia in total laryngectomy patients were related to fear and mental health. The patient communication group had improved visual analogue scale scores at one week after starting to eat. Quality of life in swallowing disorders questionnaire scores were significantly higher in the patient communication and physician communication groups than in the routine communication group. In addition, swallowing problems were much more severe in patients educated to high school level and above than in others. The patient-to-patient communication model can be used to resolve swallowing problems caused by psychological factors in total laryngectomy patients.

  13. Regional carrying capacity: case studies of Bohai Rim area

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Carrying capacity research has been carried out for a long time. However, synthesized carrying capacity researches based on systematic views began only in the 1970s. There is even less work done in China. This paper tries to address both synthesized carrying capacity research and its utilization in China. State spaces method from the systematic science was borrowed to construct the conceptual model of regional carrying capacity. Based on the conceptual model and the surveys in the Bohai Rim area, we construct a representative indicators system for quantifying regional carrying capacity in the Bohai Rim. While employing system dynamic models we simulated the evolving trend of both the regional carrying states and regional carrying capacity from 1999 to 2015. The results proved the statement that Bohai Rim is overall over-capacity for a long time and will be over-capacity in the foreseeable future. Among all the restriction factors, water shortage and environmental pollution stand out to be the two primary obstacles for Bohai Rim's sustainable development.Regional differentiation analysis further indicates that coastal areas of the Bohai Rim burden more than its overall level. However, Shandong province shows some good signs in addressing the regional carrying capacity issues. The research is successful in addressing the quantification of regional carrying capacity issues, but nonetheless it needs further refinery and more information.

  14. An empirical investigation of two competing models of patient satisfaction.

    Science.gov (United States)

    Mishra, D P; Singh, J; Wood, V

    1991-01-01

    This paper empirically examines two competing models of patient satisfaction. Specifically, a five factor SERVQUAL model proposed by Parasuraman et al. (1988) and a tripartite model posited by Smith, Bloom, and Davis (1986) are examined. The two models are tested via factor analysis based on data collected from a field survey of hospital patients. The results of this study indicate that the five dimensional SERVQUAL model is not supported by data. On the other hand, there is general support for the tripartite model. Implications of our results for health care practitioners and researchers are discussed. Future directions for research are also outlined.

  15. A data model that captures clinical reasoning about patient problems.

    Science.gov (United States)

    Barrows, R. C.; Johnson, S. B.

    1995-01-01

    We describe a data model that has been implemented for the CPMC Ambulatory Care System, and exemplify its function for patient problems. The model captures some nuances of clinical thinking about patients that are not accommodated in most other models, such as an evolution of clinical understanding about patient problems. A record of this understanding has clinical utility, and serves research interests as well as medical audit concerns. The model is described with an example, and advantages and limitations in the current implementation are discussed. PMID:8563311

  16. Modeling Safety Outcomes on Patient Care Units

    Science.gov (United States)

    Patil, Anita; Effken, Judith; Carley, Kathleen; Lee, Ju-Sung

    In its groundbreaking report, "To Err is Human," the Institute of Medicine reported that as many as 98,000 hospitalized patients die each year due to medical errors (IOM, 2001). Although not all errors are attributable to nurses, nursing staff (registered nurses, licensed practical nurses, and technicians) comprise 54% of the caregivers. Therefore, it is not surprising, that AHRQ commissioned the Institute of Medicine to do a follow-up study on nursing, particularly focusing on the context in which care is provided. The intent was to identify characteristics of the workplace, such as staff per patient ratios, hours on duty, education, and other environmental characteristics. That report, "Keeping Patients Safe: Transforming the Work Environment of Nurses" was published this spring (IOM, 2004).

  17. A pilot survey on the quality of life in respiratory rehabilitation carried out in COPD patients with severe respiratory failure: preliminary data of a novel Inpatient Respiratory Rehabilitation Questionnaire (IRRQ

    Directory of Open Access Journals (Sweden)

    Pasqua Franco

    2012-11-01

    Full Text Available Abstract Background Measuring the state of health is a method for quantifying the impact of an illness on the day-to-day life, health and wellbeing of a patient, providing a quantitative measure of an individual’s quality of life (QoL. QoL expresses patient point of view by a subjective dimension and can express the results of medical intervention. Pulmonary rehabilitation is an essential component in the management of COPD patients, and measuring QoL has become a central focus in the study of this disease. Although nowadays several questionnaires for measuring the QoL in COPD patients are available, there are no questionnaires specifically developed for evaluating QoL in COPD patients undergoing respiratory rehabilitation. The aim of this study was to develop a novel questionnaire for the QoL quantification in COPD patients undergoing in-patient pulmonary rehabilitation program. Methods The questionnaire, administered to COPD patients undergoing long-term oxygen therapy into a respiratory rehabilitation ward, was developed by a simple and graphic layout to be administered to elderly patients. It included one form for admission and another for discharge. It included only tips related to the subjective components of QoL that would be relevant for patient, although likely not strictly related to the respiratory function. A descriptive analysis was performed for the socio-demographic characteristics and both the non-parametric Wilcoxon T-test and the Cronbach’s alpha index were calculated for evaluating the sensitivity of the questionnaire to the effects of respiratory rehabilitation and for identifying its consistency. Results The physical and psychological condition of the 34 COPD patients improved after the rehabilitative treatment and this finding was detected by the questionnaire (overall improvement: 14.2±2.5%, as confirmed by the non-parametric Wilcoxon test (p Conclusions This proposed questionnaire represents a substantial innovation

  18. Models of emergency departments for reducing patient waiting times.

    Science.gov (United States)

    Laskowski, Marek; McLeod, Robert D; Friesen, Marcia R; Podaima, Blake W; Alfa, Attahiru S

    2009-07-02

    In this paper, we apply both agent-based models and queuing models to investigate patient access and patient flow through emergency departments. The objective of this work is to gain insights into the comparative contributions and limitations of these complementary techniques, in their ability to contribute empirical input into healthcare policy and practice guidelines. The models were developed independently, with a view to compare their suitability to emergency department simulation. The current models implement relatively simple general scenarios, and rely on a combination of simulated and real data to simulate patient flow in a single emergency department or in multiple interacting emergency departments. In addition, several concepts from telecommunications engineering are translated into this modeling context. The framework of multiple-priority queue systems and the genetic programming paradigm of evolutionary machine learning are applied as a means of forecasting patient wait times and as a means of evolving healthcare policy, respectively. The models' utility lies in their ability to provide qualitative insights into the relative sensitivities and impacts of model input parameters, to illuminate scenarios worthy of more complex investigation, and to iteratively validate the models as they continue to be refined and extended. The paper discusses future efforts to refine, extend, and validate the models with more data and real data relative to physical (spatial-topographical) and social inputs (staffing, patient care models, etc.). Real data obtained through proximity location and tracking system technologies is one example discussed.

  19. 25 CFR 167.6 - Carrying capacities.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Carrying capacities. 167.6 Section 167.6 Indians BUREAU... Carrying capacities. (a) The Commissioner of Indian Affairs on June 26, 1943, promulgated the authorized carrying capacity for each land management district of the Navajo Reservation. (b) Recommended...

  20. 7 CFR 1437.402 - Carrying capacity.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Carrying capacity. 1437.402 Section 1437.402... Determining Coverage of Forage Intended for Animal Consumption § 1437.402 Carrying capacity. (a) CCC will establish a carrying capacity for all grazed forage present in the county for purposes of administering...

  1. A FEMINIST READING OF SISTER CARRIE

    Institute of Scientific and Technical Information of China (English)

    高陈科

    2011-01-01

    In the history of American literature, Sister Carrie has always been a controversial character. The critics regard Carrie either as a "fallen woman" or as a "new women". This thesis aims to offer a feminist reading of the image of Sister Carrie in the con

  2. Local Dynamic Stability Associated with Load Carrying

    Directory of Open Access Journals (Sweden)

    Jian Liu

    2013-03-01

    Conclusion: Current study confirmed the sensitivity of local dynamic stability measure in load carrying situation. It was concluded that load carrying tasks were associated with declined local dynamic stability, which may result in increased risk of fall accident. This finding has implications in preventing fall accidents associated with occupational load carrying.

  3. Efficacy of HGF carried by ultrasound microbubble-cationic nano-liposomes complex for treating hepatic fibrosis in a bile duct ligation rat model, and its relationship with the diffusion-weighted MRI parameters.

    Science.gov (United States)

    Zhang, Shou-hong; Wen, Kun-ming; Wu, Wei; Li, Wen-yan; Zhao, Jian-nong

    2013-12-01

    Hepatic fibrosis is a major consequence of liver aggression. Finding novel ways for counteracting this damaging process, and for evaluating fibrosis with a non-invasive imaging approach, represent important therapeutic and diagnostic challenges. Hepatocyte growth factor (HGF) is an anti-fibrosis cell growth factor that induces apoptosis in activated hepatic stellate cells, reduces excessive collagen deposition, and stimulates hepatocyte regeneration. Thus, using HGF in gene therapy against liver fibrosis is an attractive approach. The aims of the present study were: (i) to explore the efficacy of treating liver fibrosis using HGF expression vector carried by a novel ultrasound microbubble delivery system; (ii) to explore the diagnostic interest of diffusion-weighted MRI (DWI-MRI) in evaluating liver fibrosis. We established a rat model of hepatic fibrosis. The rats were administered HGF linked to novel ultrasound micro-bubbles. Progression of hepatic fibrosis was evaluated by histopathology, hydroxyproline content, and DWI-MRI to determine the apparent diffusion coefficient (ADC). Our targeted gene therapy produced a significant anti-fibrosis effect, as shown by liver histology and significant reduction of hydroxyproline content. Moreover, using DWI-MRI, the b value (diffusion gradient factor) was equal to 300s/mm(2), and the ADC values significantly decreased as the severity of hepatic fibrosis increased. Using this methodology, F0-F2 could be distinguished from F3 and F4 (Pmicrobubble-cationic nano-liposome complex for gene delivery. The data indicate that, this approach is efficient to counteract the fibrosis process. DWI-MRI appears a promising imaging technique for evaluating liver fibrosis.

  4. [Fusing empowerment concept into patient-centered collaborative care model].

    Science.gov (United States)

    Wu, Chia-Chen; Lin, Chiu-Chu

    2014-12-01

    Chronic diseases are incurable, long-term illnesses. To improve quality of life, patients with chronic diseases must adjust their own personal lifestyle to cope with their diseases and eventually learn to achieve a balance between disease control and daily life. Therefore, self-management necessarily plays a key role in chronic disease management. Different from physician-centered healthcare, the self-management practiced by chronic disease patients is more patient-centered with a greater emphasis on active patient participation. The main goal of this article is to elucidate the essence of the empowerment concept. An example of diabetes care, this article introduces a detailed five-step application as a basic model for incorporating the empowerment concept into the healthcare of patients with chronic disease. The author suggests that healthcare providers apply the empowerment model in clinical practice to assist patients to maintain an optimal balance between their health status and personal lives.

  5. Personal models for diabetes in context and patients' health status.

    Science.gov (United States)

    Lange, Lori J; Piette, John D

    2006-06-01

    In a diverse sample of 452 adult diabetes patients, we investigated: (1) personal model dimensions for diabetes and expanded upon the literature by indexing fatalism, (2) the relationship between contextual factors and patients' beliefs about the seriousness and controllability of diabetes, and (3) the unique contribution of illness representation combinations to clinical outcomes when controlling for baseline disease severity. Major categories of predictors included patients' sociocultural characteristics, illness history (e.g., co-morbidities, diabetes complications) and recent physical symptoms. Illness representations were measured using the Personal Models of Diabetes Interview and questions that index fatalistic beliefs. Clinical outcome measures included patients' glycemic control (HbA1c) and the patient's physical and mental functions as measured by the SF-12. Analyses corroborated the literature by identifying seriousness and treatment effectiveness cognitive model dimensions for diabetes. Physical symptoms and other disease-related factors were strong predictors of patients' seriousness beliefs for diabetes, whereas sociocultural factors (education, ethnicity) best explained representations related to the controllability of diabetes (i.e., treatment effectiveness, fatalism). Seriousness beliefs were good indicators of actual glucose control, except for cases in which patients were more fatalistic and believed diabetes to be less serious. Although patients had medically consistent views of their diabetes, variations in personal models of diabetes were related to specific contextual factors and independently explained diabetes control.

  6. Modeling the effect of short stay units on patient admissions

    NARCIS (Netherlands)

    Zonderland, Maartje E.; Boucherie, Richard J.; Carter, Michael W.; Stanford, David A.

    2015-01-01

    Two purposes of Short Stay Units (SSU) are the reduction of Emergency Department crowding and increased urgent patient admissions. At an SSU urgent patients are temporarily held until they either can go home or transferred to an inpatient ward. In this paper we present an overflow model to evaluate

  7. [Problems in model-beds for tuberculosis patients].

    Science.gov (United States)

    Ito, Kunihiko; Yoshiyama, Takashi; Kato, Seiya; Ishikawa, Nobukatsu

    2009-01-01

    To investigate the possibility and obstacles to care tuberculosis patients in general hospitals. Sending questionnaire to the general and psychiatric hospitals running the model-beds for tuberculosis patients care, which have been the project proposed by Ministry of Health, Labour and Welfare, and analyzing their answers. Answer sheets were recovered from 43 of 75 (57%) hospitals which were the objects of this investigation. Situations of running the model-beds were highly diverse. 74% of the hospitals assumed that the general hospitals (if some conditions were satisfied) could care most of the tuberculosis patients. Problems in running the model-beds pointed by the hospitals were; HIC (hospital infection control) procedures pressing extra-workload (37%), low occupancy rate of the model-beds (30%), high cost of equipments for HIC (28%), high workload and high cost for tuberculosis patients care (21%), low fee for tuberculosis care (16%), difficulties of caring psychologically and/or physically unstable tuberculosis patients in rooms separate from the nurse station (16%), difficulties in long-term in-hospital care due to lack of sufficient amenities (14%), difficulties in accepting tuberculosis patients with short notice (12%), heavy burden for nurses who have to care for patients with associated conditions unfamiliar to them (12%), difficulties in maintaining quality of tuberculosis care (7%), risk of infection to the staffs and other patients (5%) and others miscellaneous problems (16%). Needs for tuberculosis patients' care in general hospitals are expected to further increase in the near future, but to cope with the above situation many problems are still to be solved. Hereafter we must expand the project of model-beds for tuberculosis care, and accumulate more experiences in tuberculosis patients' care in general hospitals.

  8. [Pathological features of hepatocellular carcinoma carrying hepatitis C virus antigen].

    Science.gov (United States)

    Liu, B; Zhu, S; Zhang, X

    1997-10-01

    To analyze the pathological features of hepatocellular carcinomas (HCCs) carrying different hepatitis virus antigens histopathologically and systematically. PAP and ABC kits were used in the immunohistochemical study, and CAS-200 System was applied in the image cytometry. As compared with HCCs carrying HBV marker(s), the HCCs carrying HCV marker showed more cases of clear cell type (7/9 vs 4/33), better differentiation of cancers, less necrosis of hepatocytes, milder lymphocyte infiltration in the hepatic sinuses or periportal areas (P < 0.01), higher incidence of bile ductule damages, and bore a close relation to the formation of lymphoid follicle in the surrounding tissues (P < 0.05). These patients were elder, with lower grade of symptoms and better prognosis after operation. HCCs carrying only HCAg have different pathological features and clinical characteristics from which carrying HBV marker(s). The results of image cytometry are in accordance with the biological behaviour of HCC.

  9. Blood-CNS Barrier Impairment in ALS Patients versus an Animal Model

    Directory of Open Access Journals (Sweden)

    Svitlana eGarbuzova-Davis

    2014-02-01

    Full Text Available Amyotrophic lateral sclerosis (ALS is a severe neurodegenerative disease with a compli-cated and poorly understood pathogenesis. Recently, alterations in the blood-Central Nervous System barrier (B-CNS-B have been recognized as a key factor possibly aggravating motor neuron damage. The majority of findings on ALS microvascular pathology have been deter-mined in mutant SOD1 rodent models, identifying barrier damage during disease develop-ment which might similarly occur in familial ALS patients carrying the SOD1 mutation. However, our knowledge of B-CNS-B competence in sporadic ALS (SALS has been limited. We recently showed structural and functional impairment in postmortem gray and white mat-ter microvessels of medulla and spinal cord tissue from SALS patients, suggesting pervasive barrier damage. Although numerous signs of barrier impairment (endothelial cell degenera-tion, capillary leakage, perivascular edema, downregulation of tight junction proteins, and microhemorrhages are indicated in both mutant SOD1 animal models of ALS and SALS pa-tients, other pathogenic barrier alterations have as yet only been identified in SALS patients. Pericyte degeneration, perivascular collagen IV expansion, and white matter capillary abnor-malities in SALS patients are significant barrier related pathologies yet to be noted in ALS SOD1 animal models. In the current review, these important differences in blood-CNS barrier damage between ALS patients and animal models, which may signify altered barrier transport mechanisms, are discussed. Understanding discrepancies in barrier condition between ALS patients and animal models may be crucial for developing effective therapies.

  10. Sister Carrie:A Material Pursuer

    Institute of Scientific and Technical Information of China (English)

    马春花

    2015-01-01

    Sister Carrie dramatized by Dreiser is totally a material pursuer. She is selfish and accumulates money in a crazy way. What she does inevitably centers on materials. Living with Drouet and later Hurstwood, Carrie gets what she wants and enjoys the luxurious life in an easy way. However, with the satisfaction of some of her desires, Carrie ’s desires grow and expand. With enough food and clothes, she needs luxury. Hurstwood’s failure in business leads Carrie to the stage and finally she makes a suc⁃cess and becomes a famous actress in Broadway. She gets more money, but her desires grow even higher. Nothing can satisfy her. In this essay, the author tries to analyze Carrie according to Freud’s and Guo Weilu’s theories and prove that Carrie is totally a material pursuer.

  11. A Patient-Specific Airway Branching Model for Mechanically Ventilated Patients

    Directory of Open Access Journals (Sweden)

    Nor Salwa Damanhuri

    2014-01-01

    Full Text Available Background. Respiratory mechanics models have the potential to guide mechanical ventilation. Airway branching models (ABMs were developed from classical fluid mechanics models but do not provide accurate models of in vivo behaviour. Hence, the ABM was improved to include patient-specific parameters and better model observed behaviour (ABMps. Methods. The airway pressure drop of the ABMps was compared with the well-accepted dynostatic algorithm (DSA in patients diagnosed with acute respiratory distress syndrome (ARDS. A scaling factor (α was used to equate the area under the pressure curve (AUC from the ABMps to the AUC of the DSA and was linked to patient state. Results. The ABMps recorded a median α value of 0.58 (IQR: 0.54–0.63; range: 0.45–0.66 for these ARDS patients. Significantly lower α values were found for individuals with chronic obstructive pulmonary disease (P<0.001. Conclusion. The ABMps model allows the estimation of airway pressure drop at each bronchial generation with patient-specific physiological measurements and can be generated from data measured at the bedside. The distribution of patient-specific α values indicates that the overall ABM can be readily improved to better match observed data and capture patient condition.

  12. Measuring Social Carrying Capacity: An Exploratory Study

    OpenAIRE

    López-Bonilla, Jesús Manuel; López-Bonilla, Luis Miguel

    2007-01-01

    The tourist carrying capacity commands a growing interest given that it is closely linked with sustainable tourist development. The justification of the utility of this concept is given by means of a simple and efficient methodological proposal, by analysing the social carrying capacity. To this end, an empirical application is carried out in the Western Andalusia. In some of the cases analysed, the satisfaction of the tourist is found to decline when the levels of the tourist use are higher ...

  13. ENVIRONMENTAL CARRYING CAPACITY BASED ON SPATIAL PLANNING

    OpenAIRE

    Luthfi Muta'ali

    2013-01-01

    The aims of this research were to examine environmental carrying capacity analyzed based on aspects of spatial planning and eco-region. The result showed that Kulonprogo Regency has low value of environmental carrying capacity and can only support as much as 79.81% of its total population. Analysis of variance showed significant difference of environmental carrying capacity of protected and cultivated area. The main factor among 12 variables determining the degree of environmen...

  14. Characterization of Cardiac Patients Based on the Synergy Model

    Directory of Open Access Journals (Sweden)

    Tavangar

    2014-10-01

    Full Text Available Background Cardiac patients need comprehensive support due to the adverse effects of this disease on different aspects of their lives. Synergy intervention is a model that focuses on patients' requirements. Objectives This study aimed to determine the eightfold characteristic of cardiac patients based on the synergy model that represent their clinical requirements. Materials and Methods In this descriptive cross-sectional study, 40 cardiac patients hospitalized at the cardiac care unit (CCU of Yazd Afshar Hospital were randomly selected. The data were collected by using a two-part check-list including demographic characteristics and also by studying eight characteristics of patients through interviewing and reviewing their records. The results were analyzed using descriptive statistics such as frequency (percentage and analytical statistics such as Spearman and Mann-Whitney test with the SPSS software, version 18. Results The results showed that among patients' internal characteristics, reversibility (70.6%, vulnerability (68.6%, and predictability (80.4% at level 1 (the minimum score had the highest frequency and stability (49% and complexity (54.9% were at level 3 (average score. Among external characteristics participation in decision-making (80.4% at level 1 had the highest frequency while care (62.7% and recourses (98% were at level 3. Conclusions Ignoring any of the eightfold characteristics based on the synergy model interferes with comprehensive support of cardiac patients. Therefore, it is necessary for professional health practitioners, especially nurses, to consider patients' eightfold characteristics in order to provide quality care.

  15. Cancer patient-centered home care: a new model for health care in oncology

    Directory of Open Access Journals (Sweden)

    Tralongo P

    2011-09-01

    Full Text Available Paolo Tralongo1, Francesco Ferraù2, Nicolò Borsellino3, Francesco Verderame4, Michele Caruso5, Dario Giuffrida6, Alfredo Butera7, Vittorio Gebbia81Medical Oncology Unit, Azienda Sanitaria Provinciale, Siracusa; 2Medical Oncology Unit, Ospedale San Vincenzo, Taormina; 3Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo; 4Medical Oncology Unit, Ospedale Giovanni Paolo II, Sciacca; 5Medical Oncology Unit, Istituto Humanitas, Catania; 6Medical Oncology Unit, Istituto Oncologico del Mediterraneo, Catania; 7Medical Oncology Unit, Ospedale San Giovanni di Dio, Agrigento; 8Medical Oncology Unit, Dipartimento Oncologico, La Maddalena, Università degli Studi, Palermo, ItalyAbstract: Patient-centered home care is a new model of assistance, which may be integrated with more traditional hospital-centered care especially in selected groups of informed and trained patients. Patient-centered care is based on patients' needs rather than on prognosis, and takes into account the emotional and psychosocial aspects of the disease. This model may be applied to elderly patients, who present comorbid diseases, but it also fits with the needs of younger fit patients. A specialized multidisciplinary team coordinated by experienced medical oncologists and including pharmacists, psychologists, nurses, and social assistance providers should carry out home care. Other professional figures may be required depending on patients' needs. Every effort should be made to achieve optimal coordination between the health professionals and the reference hospital and to employ shared evidence-based guidelines, which in turn guarantee safety and efficacy. Comprehensive care has to be easily accessible and requires a high level of education and knowledge of the disease for both the patients and their caregivers. Patient-centered home care represents an important tool to improve quality of life and help cancer patients while also being cost effective.Keywords: cancer, home care

  16. Phenotype and genotype of deaf patients with combined genomic and mitochondrial inheritance models.

    Science.gov (United States)

    Huang, Shasha; Wang, Guojian; Jiang, Yi; Yuan, Yongyi; Han, Dongyi; Song, Yueshuai; Dai, Pu

    2013-11-01

    In most studies, sensorineural hearing loss is reported as a single-gene disease with autosomal dominant or autosomal recessive or with X-linked or maternal inheritance. It is uncommon that the hearing impairment is caused by a combined inheritance model including genomic and mitochondrial models. Here, we report six patients with sensorineural hearing loss caused by co-existing mutations in GJB2 or SLC26A4 and the mitochondrial gene. And there was no significant difference in hearing phenotypes between the six patients and the controls. The results indicate the complicated genetic etiology of, and may impact the diagnostic strategy for, hereditary hearing impairment. All patient siblings will carry mitochondrial DNA A1555G or C1494T mutations, and 25% of siblings may carry the same homozygous or compound heterozygote mutations in GJB2 or SLC26A4. Although this combined inheritance is not common in the Chinese deaf population (0.10%), our findings will have great impact in genetic counseling and risk prediction for deafness.

  17. Make patients satisfied "sunshine hospital " by carrying out hospital fees audit work%做好医院住院收费审核工作打造患者满意的"阳光医院"

    Institute of Scientific and Technical Information of China (English)

    蔡欣芸; 王琳娜; 苑萍

    2011-01-01

    为规范住院收费管理,我院设立了费用审核室,由它对全院待出院病历进行人工审核,从而有效杜绝多收、漏收、重复记账和医嘱、病历不完整等不良情况出现.此举措不仅认真贯彻落实了政府关于规范使用医疗价格及医疗收费的文件精神,而且化解了医患矛盾,避免了医疗纠纷,维护了医患双方的利益,提高了医院的信誉度.%Cost audit office has been set to regulate the hospitalization tolling management. The function of the office is to manually review all the discharge medical records of the hospital. This measure effectively eliminates the appearance of default situations. such as extra charge. leak charge, repeat charge and doctor's advice or medical record incomplete. etc. The measure not only implements the spirit of the government policy of regulating medical price, but also resolves the doctor-patient conflicts. avoids medical dispute, safeguards both of the doctor and patient s interests and improves the hospital creditworthiness.

  18. Detection of the influenza A(H1N1)pdm09 virus carrying the K-15E, P83S and Q293H mutations in patients who have undergone bone marrow transplant.

    Science.gov (United States)

    Mesquita, Milene; Resende, Paola; Marttorelli, Andressa; Machado, Viviane; Sacramento, Carolina Q; Fintelman-Rodrigues, Natalia; Abrantes, Juliana L; Tavares, Rita; Schirmer, Marcelo; Siqueira, Marilda M; Souza, Thiago Moreno L

    2014-01-01

    The 2009 pandemic influenza A(H1N1)pdm09 virus emerged and caused considerable morbidity and mortality in the third world, especially in Brazil. Although circulating strains of A(H1N1)pdm09 are A/California/04/2009-like (CA-04-like) viruses, various studies have suggested that some mutations in the viral hemagglutinin (HA) may be associated with enhanced severity and fatality. This phenomenon is particularly challenging for immunocompromised individuals, such as those who have undergone bone marrow transplant (BMT), because they are more likely to display worse clinical outcomes to influenza infection than non-immunocompromised individuals. We studied the clinical and viral aspects of post-BMT patients with confirmed A(H1N1)pdm09 diagnosis in the largest cancer hospital in Brazil. We found a viral strain with K-15E, P83S and Q293H polymorphisms in the HA, which is presumably more virulent, in these individuals. Despite that, these patients showed only mild symptoms of infection. Our findings complement the discovery of mild cases of infection with the A(H1N1)pdm09 virus with the K-15E, P83S and Q293H mutations in Brazil and oppose other studies that have linked these changes with increased disease severity. These results could be important for a better comprehension of the impact of the pandemic influenza in the context of BMT.

  19. Modeling neurodegenerative diseases with patient-derived induced pluripotent cells

    DEFF Research Database (Denmark)

    Poon, Anna; Zhang, Yu; Chandrasekaran, Abinaya

    2017-01-01

    patient-specific induced pluripotent stem cells (iPSCs) and isogenic controls generated using CRISPR-Cas9 mediated genome editing. The iPSCs are self-renewable and capable of being differentiated into the cell types affected by the diseases. These in vitro models based on patient-derived iPSCs provide...... the possibilities of generating three-dimensional (3D) models using the iPSCs-derived cells and compare their advantages and disadvantages to conventional two-dimensional (2D) models....

  20. Interventional patient hygiene model: Infection control and nursing share responsibility for patient safety.

    Science.gov (United States)

    McGuckin, Maryanne; Shubin, Arlene; Hujcs, Marianne

    2008-02-01

    Interventional patient hygiene (IPH) has been defined as a comprehensive evidence-based intervention and measurement model for reducing the bioburden of both the patient and health care worker. The components of IPH are hand hygiene, oral care, skin care/antisepsis, and catheter site care. This practice form will provide evidence-based information for each of the components of IPH model and provide a strategy for the development, implementation, and monitoring of IPH protocols.

  1. Nurse-patient assignment models considering patient acuity metrics and nurses' perceived workload.

    Science.gov (United States)

    Sir, Mustafa Y; Dundar, Bayram; Barker Steege, Linsey M; Pasupathy, Kalyan S

    2015-06-01

    Patient classification systems (PCSs) are commonly used in nursing units to assess how many nursing care hours are needed to care for patients. These systems then provide staffing and nurse-patient assignment recommendations for a given patient census based on these acuity scores. Our hypothesis is that such systems do not accurately capture workload and we conduct an experiment to test this hypothesis. Specifically, we conducted a survey study to capture nurses' perception of workload in an inpatient unit. Forty five nurses from oncology and surgery units completed the survey and rated the impact of patient acuity indicators on their perceived workload using a six-point Likert scale. These ratings were used to calculate a workload score for an individual nurse given a set of patient acuity indicators. The approach offers optimization models (prescriptive analytics), which use patient acuity indicators from a commercial PCS as well as a survey-based nurse workload score. The models assign patients to nurses in a balanced manner by distributing acuity scores from the PCS and survey-based perceived workload. Numerical results suggest that the proposed nurse-patient assignment models achieve a balanced assignment and lower overall survey-based perceived workload compared to the assignment based solely on acuity scores from the PCS. This results in an improvement of perceived workload that is upwards of five percent. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Improving patient information leaflets: developing and applying an evaluative model of patient-centredness for text.

    Science.gov (United States)

    Fage-Butler, Antoinette

    2013-01-01

    The purpose of this paper is to present an evaluative model of patient-centredness for text and to illustrate how this can be applied to patient information leaflets (PILs) that accompany medication in the European Union. Patients have criticized PILs for sidelining their experiences, knowledge and affective needs, and denying their individuality. The health communication paradigm of patient-centredness provides valuable purchase on these issues, taking its starting point in the dignity and integrity of the patient as a person. Employing this evaluative model involves two stages. First, a Foucauldian Discourse Analysis is performed of sender and receiver and of the main discourses in PILs. These aspects are then evaluated using the perspectives of patient-centredness theory relating to the medical practitioner, patient and content. The evaluative model is illustrated via a PIL for medication for depression and panic attacks. Evaluation reveals a preponderance of biomedical statements, with a cluster of patient-centred statements primarily relating to the construction of the patient. The paper contributes a new method and evaluative approach to PIL and qualitative health research, as well as outlining a method that facilitates the investigation of interdiscursivity, a recent focus of critical genre analysis.

  3. Bivalve carrying capacity in coastal ecosystems

    NARCIS (Netherlands)

    Dame, R.F.; Prins, T.C.

    1998-01-01

    carrying capacity of suspension feeding bivalves in 11 coastal and estuarine ecosystems is examined. Bivalve carrying capacity is defined in terms of water mass residence time, primary production time and bivalve clearance time. Turnover times for the 11 ecosystems are compared both two and three di

  4. Comments on the image of Sister Carrie

    Institute of Scientific and Technical Information of China (English)

    张楠

    2016-01-01

    Thedore Oreiser was one of America's greatest writers and one of his famous masterpieces is Sister Carrie. the heroin of the novel was a country girl who struggled for success and finally became a movie star. Analysis on the image of Carrie is of practical significance to the country girls swarming into the city nowdays in our country.

  5. Carrie Chapman Catt and Woman Suffrage.

    Science.gov (United States)

    Hardesty, Carolyn, Ed.

    1989-01-01

    Most of the material for this issue of the "Goldfinch," which explores the life of Carrie Chapman Catt, came from the archives of the State Historical Society of Iowa. Carrie Chapman Catt (1859-1947) was an Iowan who advocated woman suffrage and spent 26 years actively working for that cause. The issue contains a biography of Catt, and…

  6. Parallelization of Reversible Ripple-carry Adders

    DEFF Research Database (Denmark)

    Thomsen, Michael Kirkedal; Axelsen, Holger Bock

    2009-01-01

    The design of fast arithmetic logic circuits is an important research topic for reversible and quantum computing. A special challenge in this setting is the computation of standard arithmetical functions without the generation of \\emph{garbage}. Here, we present a novel parallelization scheme...... wherein $m$ parallel $k$-bit reversible ripple-carry adders are combined to form a reversible $mk$-bit \\emph{ripple-block carry adder} with logic depth $\\mathcal{O}(m+k)$ for a \\emph{minimal} logic depth $\\mathcal{O}(\\sqrt{mk})$, thus improving on the $mk$-bit ripple-carry adder logic depth $\\mathcal......{O}(m\\cdot k)$. The underlying mechanisms of the parallelization scheme are formally proven correct. We also show designs for garbage-less reversible comparison circuits. We compare the circuit costs of the resulting ripple-block carry adder with known optimized reversible ripple-carry adders in measures...

  7. The Concept of Carrying Capacity in Tourism

    Directory of Open Access Journals (Sweden)

    Josef Zelenka

    2014-05-01

    Full Text Available Carrying capacity is often pragmatically, theoretically as well as purely intuitively considered as a concept in the context of tourism sustainability. The carrying capacity application has the greatest potential in protected areas, in frequently visited cultural and natural attractions, and in relation to sustaining of the lifestyle of the local community and tourism destination potential in general. Despite its importance, partial applications, determination of basic theoretical principles, and specifying connection to the other theoretical concepts in tourism (particularly destination life cycle, LAC concept, visitors management, there still is a rightful opinion of some authors suggesting that there is no consistent theory of tourism carrying capacity. This theory would be the base for sophisticated practical carrying capacity applications. This paper is therefore focused on introduction of the theoretical concept of carrying capacity, which can be discussed and possibly further elaborated.

  8. Sister Carrie, an Adherent of Desires

    Institute of Scientific and Technical Information of China (English)

    裴水妹

    2007-01-01

    Sister Carrie is one of the most controversial characters in American literature.Thought as a "fallen woman" firstly,she was defined as a "new woman" by some critics later. However, by digging into the motivaton behind the whole process of Carrie's "success", the relationship between Carrie and her creator (the author), the social conditions of then American, it can be found that Carrie has never been free-standing on her thought and she has never found her real-sdf even after becoming a famous actress. In a society dominated by mass consumerism Carrie is only an adherent of her own desires. She also is a representative of all those country girls flooded into cities, a symbol and a sacrifice of the urbanization of America in a time countryside was overcome by cities.

  9. Putting patients first: a novel patient-centered model for medical enterprise success.

    Science.gov (United States)

    Dhawan, Naveen

    2014-01-01

    This article introduces a new way of viewing patient-customers. It encourages a greater emphasis on patients' needs and the importance of considering dimensions of the patient experience to better serve them. It also draws from examples in the general business world as they can be applied to medical enterprises. The author introduces a model that directs all business activities toward the end consumer with an underlying guidance by patient needs. A business is advised to understand its customer, design a patient-directed vision, and focus on creating a unique customer experience. The article delineates key action items for physicians and administrators that will allow them to better meet their patient-customers' needs and develop loyalty. By practicing a patient-centered approach and following these guidelines, one may ensure greater success of the medical enterprise.

  10. Multidisciplinary Care Models for Patients With Psoriatic Arthritis.

    Science.gov (United States)

    Queiro, Rubén; Coto, Pablo; Rodríguez, Jesús; Notario, Jaume; Navío Marco, Teresa; de la Cueva, Pablo; Pujol Busquets, Manel; García Font, Mercè; Joven, Beatriz; Rivera, Raquel; Alvarez Vega, Jose Luis; Chaves Álvarez, Antonio Javier; Sánchez Parera, Ricardo; Ruiz Carrascosa, Jose Carlos; Rodríguez Martínez, Fernando José; Pardo Sánchez, José; Feced Olmos, Carlos; Pujol, Conrad; Galindez, Eva; Pérez Barrio, Silvia; Urruticoechea Arana, Ana; Hergueta, Mercedes; Luelmo, Jesús; Gratacós, Jordi

    To describe (structure, processes) of the multidisciplinary care models in psoriatic arthritis (PsA) in Spain, as well as barriers and facilitators of their implementation. A qualitative study was performed following structured interviews with 24 professionals (12 rheumatologists, 12 dermatologists who provide multidisciplinary care for patients with PsA). We collected data related to the hospital, department, population and multidisciplinary care model (type, physical and human resources, professional requirements, objectives, referral criteria, agendas, protocols, responsibilities, decision- making, research and education, clinical sessions, development and planning of the model, advantages and disadvantages of the model, barriers and facilitators in the implementation of the model. The models characteristics are described. We analyzed 12 multidisciplinary care models in PsA, with at least 1-2 years of experience, and 3 subtypes of models, face-to-face, parallel, and preferential circuit. All are adapted to the hospital and professionals characteristics. A proper implementation planning is essential. The involvement and empathy between professionals and an access and well-defined referral criteria are important facilitators in the implementation of a model. The management of agendas and data collection to measure the multidisciplinary care models health outcomes are the main barriers. There are different multidisciplinary care models in PsA that can improve patient outcomes, system efficiency and collaboration between specialists. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  11. About rats and jackfruit trees: modeling the carrying capacity of a Brazilian Atlantic Forest spiny-rat Trinomys dimidiatus (Günther, 1877) – Rodentia, Echimyidae – population with varying jackfruit tree (Artocarpus heterophyllus L.) abundances

    OpenAIRE

    Mello,JHF; Moulton,TP; Raíces,DSL; Bergallo,HG.

    2015-01-01

    We carried out a six-year study aimed at evaluating if and how a Brazilian Atlantic Forest small mammal community responded to the presence of the invasive exotic species Artocarpus heterophyllus, the jackfruit tree. In the surroundings of Vila Dois Rios, Ilha Grande, RJ, 18 grids were established, 10 where the jackfruit tree was present and eight were it was absent. Previous results indicated that the composition and abundance of this small mammal community were altered by the presence and d...

  12. Modeling patient safety incidents knowledge with the Categorial Structure method.

    Science.gov (United States)

    Souvignet, Julien; Bousquet, Cédric; Lewalle, Pierre; Trombert-Paviot, Béatrice; Rodrigues, Jean Marie

    2011-01-01

    Following the WHO initiative named World Alliance for Patient Safety (PS) launched in 2004 a conceptual framework developed by PS national reporting experts has summarized the knowledge available. As a second step, the Department of Public Health of the University of Saint Etienne team elaborated a Categorial Structure (a semi formal structure not related to an upper level ontology) identifying the elements of the semantic structure underpinning the broad concepts contained in the framework for patient safety. This knowledge engineering method has been developed to enable modeling patient safety information as a prerequisite for subsequent full ontology development. The present article describes the semantic dissection of the concepts, the elicitation of the ontology requirements and the domain constraints of the conceptual framework. This ontology includes 134 concepts and 25 distinct relations and will serve as basis for an Information Model for Patient Safety.

  13. Gun Carrying by High School Students in Boston, MA: Does Overestimation of Peer Gun Carrying Matter?

    Science.gov (United States)

    Hemenway, David; Vriniotis, Mary; Johnson, Renee M.; Miller, Matthew; Azrael, Deborah

    2011-01-01

    This paper investigates: (1) whether high school students overestimate gun carrying by their peers, and (2) whether those students who overestimate peer gun carrying are more likely to carry firearms. Data come from a randomly sampled survey conducted in 2008 of over 1700 high school students in Boston, MA. Over 5% of students reported carrying a…

  14. Gun Carrying by High School Students in Boston, MA: Does Overestimation of Peer Gun Carrying Matter?

    Science.gov (United States)

    Hemenway, David; Vriniotis, Mary; Johnson, Renee M.; Miller, Matthew; Azrael, Deborah

    2011-01-01

    This paper investigates: (1) whether high school students overestimate gun carrying by their peers, and (2) whether those students who overestimate peer gun carrying are more likely to carry firearms. Data come from a randomly sampled survey conducted in 2008 of over 1700 high school students in Boston, MA. Over 5% of students reported carrying a…

  15. Carry Select Adder Circuit with A Successively Incremented Carry Number Block

    OpenAIRE

    Deepak; Bal Krishan

    2014-01-01

    This paper reports a conditional carry select (CCS) adder circuit with a successively-incremented-carry-number block (SICNB) structure for low-voltage VLSI implementation. Owing to the successively-incremented-carry-number block (SICNB) structure, the new 16-bit SICNB CCS adder provides a 37% faster speed as compared to the conventional conditional Carry select adder based on the SPICE results

  16. Molecular cytogenetic analyses of HIG, a novel human cell line carrying t(1;3)(p36.3;q25.3) established from a patient with chronic myelogenous leukemia in blastic crisis.

    Science.gov (United States)

    Hosoya, Noriko; Ogawa, Seishi; Motokura, Tohru; Hangaishi, Akira; Wang, Lili; Qiao, Ying; Nannya, Yasuhito; Kogi, Mieko; Hirai, Hisamaru

    2003-12-01

    Chromosomal abnormalities involving 1p36, 3q21, and/or 3q26 have been reported in a subset of myeloid neoplasms having characteristic dysmegakaryopoiesis, and the overexpression of EVI1 on 3q26 or of MEL1 on 1p36 has been implicated in their pathogenesis. We describe molecular cytogenetic analyses of a novel human cell line, HIG, established from a unique case in which a novel translocation t(1;3)(p36;q26) appeared as the sole additional chromosomal abnormality at the time of blastic transformation of chronic myelogenous leukemia. The patient displayed clinical features resembling those of the 3q21q26 syndrome. The HIG cell line retained der(1)t(1;3)(p36;q26) but lost t(9;22)(q34;q11). To identify the relevant gene that would be deregulated by this translocation, we molecularly cloned the translocation's breakpoints. They were distant from the breakpoint cluster regions of the 3q21q26 syndrome or t(1;3)(p36;q21), and neither the EVI1 nor the MEL1 transcript was detected in the HIG cell line. None of the genes located within 150 kilobase pairs of the breakpoints were aberrantly expressed, suggesting that in this case other gene(s) more distant from the breakpoints are deregulated by possible remote effects. Further analyses of the deregulated genes in the HIG cell line should provide important insight into the mechanisms involved in these types of leukemias.

  17. Research on Psychological Carrying Capacity of Tourism Destination

    Institute of Scientific and Technical Information of China (English)

    Fan Zhiyong; Zhong Sheng

    2009-01-01

    As a part of the carrying capacity system of tourism destination,tourism psychological carrying capacity and its makeup are very important indexes which reflect the harmonious development of tourism destination develops harmoniously,but the academy has not paid enough attention to them.Based on the concept and connotation of psychological carrying capacity,this paper explains the influencing factors which affect the psychological capacity of the tourist and the resident after the acknowledged concept,and then designs a harmonious development model of tourism destination.Finally,it offers some countermeasures against the overloading psychological capacity.

  18. Global change and carrying capacity: Implications for life on Earth

    Science.gov (United States)

    Ehrlich, Paul R.; Daily, Gretchen C.; Ehrlich, Anne H.; Matson, Pamela; Vitousek, Peter

    1989-01-01

    Determining the long-term number of people that the planet can support without irreversibly reducing its ability to support people in the future, i.e., the carrying capacity of the Earth, is an exceedingly complex problem. About all that is known for certain is that, with present and foreseeable technologies, the human population has already exceeded the capacity. The reduction in carrying capacity that can be expected to result from direct human impacts on resources and the environment and from our indirect impacts of the climate system is discussed. Global warming and modeling global change and food security are also discussed with respect to carrying capacity.

  19. Global change and carrying capacity: Implications for life on Earth

    Science.gov (United States)

    Ehrlich, Paul R.; Daily, Gretchen C.; Ehrlich, Anne H.; Matson, Pamela; Vitousek, Peter

    1989-01-01

    Determining the long-term number of people that the planet can support without irreversibly reducing its ability to support people in the future, i.e., the carrying capacity of the Earth, is an exceedingly complex problem. About all that is known for certain is that, with present and foreseeable technologies, the human population has already exceeded the capacity. The reduction in carrying capacity that can be expected to result from direct human impacts on resources and the environment and from our indirect impacts of the climate system is discussed. Global warming and modeling global change and food security are also discussed with respect to carrying capacity.

  20. Effects of carrying methods and box handles on two-person team carrying capacity for females.

    Science.gov (United States)

    Wu, Swei-Pi; Chang, Shu-Yu

    2010-07-01

    This study used a psychophysical approach to examine the effects of carrying methods and the presence or absence of box handles on the maximum acceptable weight carried and resulting responses (heart rate and rating of perceived exertion) in a two-person carrying task. After training, 16 female subjects performed a two-person carrying task at knuckle height for an 8-h work period. Each subject performed 4 different carrying combinations two times. The independent variables were carrying methods (parallel and tandem walking) and box handles (with and without handles). For comparison with two-person carrying, the subjects also performed one-person carrying. The results showed that the maximum acceptable weight carried (MAWC), heart rate (HR), and rating of perceived exertion (RPE) were significantly affected by the presence of box handles. However, the subjects' MAWC, HR, and RPE values were not significantly influenced by the carrying methods. The test-retest reliability of the psychophysical approach was 0.945. The carrying efficiency of two-person carrying was 96.2% of the one-person carrying method. In general, the use of box with handles allows the subjects to carry a higher MAWC (with lower HR and RPE) compared to carrying boxes without handles.

  1. Patient-specific modeling of human cardiovascular system elements

    Science.gov (United States)

    Kossovich, Leonid Yu.; Kirillova, Irina V.; Golyadkina, Anastasiya A.; Polienko, Asel V.; Chelnokova, Natalia O.; Ivanov, Dmitriy V.; Murylev, Vladimir V.

    2016-03-01

    Object of study: The research is aimed at development of personalized medical treatment. Algorithm was developed for patient-specific surgical interventions of the cardiovascular system pathologies. Methods: Geometrical models of the biological objects and initial and boundary conditions were realized by medical diagnostic data of the specific patient. Mechanical and histomorphological parameters were obtained with the help mechanical experiments on universal testing machine. Computer modeling of the studied processes was conducted with the help of the finite element method. Results: Results of the numerical simulation allowed evaluating the physiological processes in the studied object in normal state, in presence of different pathologies and after different types of surgical procedures.

  2. Modeling of patient's blood pressure variation during ambulance transportation

    Science.gov (United States)

    Sakatani, Kenji; Ono, Takahiko; Kobayasi, Yasuhide; Hikita, Shinichi; Saito, Mitsuyuki

    2007-12-01

    In an emergency transportation by ambulance, a patient is transported in a supine position. In this position, a patient's blood pressure (BP) variation depending on an inertial force which occurs when an ambulance accelerates or decelerates. This BP variation causes a critical damage for a patent with brain disorder. In order to keep a patient stable during transportation, it is required to maintain small BP variation. To analyze the BP variation during transportation, a model of the BP variation has so far been made. But, it can estimate the BP variation only in braking. The purpose of this paper is to make a dynamical model of the BP variation which can simulate it in both braking and accelerating. First, to obtain the data to construct the model, we used a tilting bed to measure a head-to-foot acceleration and BP of fingertip. Based on this data, we build a mathematical model whose input is the head-to-foot acceleration and output is the Mean BP variation. It is a switched model which switches two models depending on the jerk. We add baroreceptor reflex to the model as a offset value.

  3. Gravitational waves carrying orbital angular momentum

    CERN Document Server

    Bialynicki-Birula, Iwo

    2015-01-01

    Spinorial formalism is used to map every electromagnetic wave into the gravitational wave (within the linearized gravity). In this way we can obtain the gravitational counterparts of Bessel, Laguerre-Gauss, and other light beams carrying orbital angular momentum.

  4. POPULATION DENSITIES AND THE RANGE-CARRYING ...

    African Journals Online (AJOL)

    CAPACITY FOR LARGE MAMMALS IN QUEEN ELIZABETH ... The highest known densities oflarge terrestrial mammals occur on the grasslands in ...... It is estimated that the proper average biomass carrying capacity for the several herbivore.

  5. Transgenic cassava lines carrying heterologous alternative oxidase ...

    African Journals Online (AJOL)

    To screen positive lines for gene function, leaf lobes from two transgenic lines with a line carrying an empty vector and the wild type were subjected to somatic embryogenesis (SE), a known oxidative ... African Journal of Biotechnology Vol.

  6. A Naturalistic Reading of Sister Carrie

    Institute of Scientific and Technical Information of China (English)

    谈月

    2016-01-01

    Sister Carrie is well known as the works in which naturalism attained maturity in America. Up until now, the relevant research on Dreiser and his Sister Carrie abroad and at home is primarily concerned with the frustration of American dream, the naturalistic thoughts and pessimism. The paper attempts to study it from naturalistic point of view and explain how environmental, hereditary factors and the idea of“survival of the fittest”influence Carrie’s fate.

  7. The development of a model of dignity in illness based on qualitative interviews with seriously ill patients.

    Science.gov (United States)

    van Gennip, Isis E; Pasman, H Roeline W; Oosterveld-Vlug, Mariska G; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

    2013-08-01

    While knowledge on factors affecting personal dignity of patients nearing death is quite substantial, far less is known about how patients living with a serious disease understand dignity. To develop a conceptual model of dignity that illuminates the process by which serious illness can undermine patients' dignity, and that is applicable to a wide patient population. Qualitative interview study. 34 patients with either cancer, early stage dementia, or a severe chronic illness were selected from an extensive cohort study into advance directives. In-depth interviews were carried out exploring the experiences of seriously ill patients with regard to their personal dignity. The interview transcripts were analyzed using thematic analysis and a conceptual model was constructed based on the resulting themes. We developed a two-step dignity model of illness. According to this model, illness related conditions do not affect patients' dignity directly but indirectly by affecting the way patients perceive themselves. We identified three components shaping self-perception: (a) the individual self: the subjective experiences and internally held qualities of the patient; (b) the relational self: the self within reciprocal interaction with others; and, (c) the societal self: the self as a social object in the eyes of others. The merits of the model are two-folded. First, it offers an organizing framework for further research into patients' dignity. Secondly, the model can serve to facilitate care for seriously ill patients in practice by providing insight into illness and dignity at the level of the individual patient where intervention can be effectively targeted. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Cognitive Load in Voice Therapy Carry-Over Exercises

    Science.gov (United States)

    Iwarsson, Jenny; Morris, David Jackson; Balling, Laura Winther

    2017-01-01

    Purpose: The cognitive load generated by online speech production may vary with the nature of the speech task. This article examines 3 speech tasks used in voice therapy carry-over exercises, in which a patient is required to adopt and automatize new voice behaviors, ultimately in daily spontaneous communication. Method: Twelve subjects produced…

  9. The standard data model approach to patient record transfer.

    Science.gov (United States)

    Canfield, K; Silva, M; Petrucci, K

    1994-01-01

    This paper develops an approach to electronic data exchange of patient records from Ambulatory Encounter Systems (AESs). This approach assumes that the AES is based upon a standard data model. The data modeling standard used here is IDEFIX for Entity/Relationship (E/R) modeling. Each site that uses a relational database implementation of this standard data model (or a subset of it) can exchange very detailed patient data with other such sites using industry standard tools and without excessive programming efforts. This design is detailed below for a demonstration project between the research-oriented geriatric clinic at the Baltimore Veterans Affairs Medical Center (BVAMC) and the Laboratory for Healthcare Informatics (LHI) at the University of Maryland.

  10. 乳腺癌患者携带PICC化疗并发导管败血症的诊治探讨%Diagnosis and treatment of peripherally inserted central catheters (PICC)-related sepsis in breast cancer patients carrying PICC catheter for chemotherapy

    Institute of Scientific and Technical Information of China (English)

    Lei Xing; Vishnu Prasad Adhikari; Lingquan Kong; Hongyuan Li; Guosheng Ren; Feng Luo; Kainan Wu

    2012-01-01

    Objective: The aim of our research was to study the incidence, clinical diagnosis and treatment of peripherally inserted central catheters (PICC)-related sepsis in breast cancer patients carrying PICC catheter for chemotherapy. Methods: The data of the incidence, diagnosis and treatment of PICC-related sepsis in 215 cases of breast cancer patients carrying PICC catheter for chemotherapy in our hospital from August, 2009 to September, 2011 were analyzed retrospectively. Results: 216 PICCs had been successfully applied in 215 cases of breast cancer patients and followed for a total of 19,109 catheter days, (median catheterization duration, 88.9 days, range 1-212 days). Among those, 3 (1.39%) PICCs were removed respectively as a result of PICC-related sepsis in 29, 73 and 108 catheter-days (median 70 d), with a rate of 0.16 per 1000 catheter-days. Conclusion: Chemotherapeutic treatment via PICC for breast cancer patients is one of the most secure and effective measures but there exists small number of cases in which PICC catheter related sepsis is possible. Careful observation of relevant symptoms and signs, early diagnosis and treatment, not relying completely on blood culture tests and timely removal of PICC catheter can be very effective in treating PICC-related sepsis in these patients.

  11. Effects of box handle position and carrying range on bi-manual carrying capacity for females.

    Science.gov (United States)

    Wu, Swei-Pi; Loiu, Yi; Chien, Te Hong

    2015-01-01

    This study utilizes a psychophysical approach to examine the effects on carrying capacity for bi-manual carrying tasks involving different handle positions and carrying ranges. A total of 16 female subjects participated in the experiment in groups of two people, and each group of subjects performed the tasks in a random order with 12 different combinations of carrying task. The independent variables are handle position (upper, middle, lower) and carrying range (F-F: floor height carried to floor height, F-W: floor height carried to waist height, W-W: waist height carried to waist height, W-F: waist height carried to floor height), the dependent variable is the maximum acceptable carried weight (MAWC), heart rate (HR), and the rating of perceived exertion (RPE). The results show that the handle position has a significant effect on MAWC and overall RPE but no significant effect on HR. Carrying range has a significant effect on the MAWC and HR, but no significant effect on overall HR. The handle position and carrying range have a significant interaction on the MAWC and HR. The RPE for different body parts shows significant differences, and the hands feel the most tired. Overall, this study confirms that the lower handle position with the W-W carrying range is the best combination for a two-person carrying task.

  12. Roy's Adaptation Model-Based Patient Education for Promoting the Adaptation of Hemodialysis Patients.

    Science.gov (United States)

    Afrasiabifar, Ardashir; Karimi, Zohreh; Hassani, Parkhideh

    2013-07-01

    In addition to physical adaptation and psychosocial adjustment to chronic renal disease, hemodialysis (HD) patients must also adapt to dialysis therapy plan. The aim of the present study was to examine the effect of Roy's adaptation model-based patient education on adaptation of HD patients. This study is a semi-experimental research that was conducted with the participation of all patients with end-stage renal disease referred to the dialysis unit of Shahid Beheshti Hospital of Yasuj city, 2010. A total of 59 HD patients were randomly allocated to two groups of test and control. Data were collected by a questionnaire based on the Roy's Adaptation Model (RAM). Validity and reliability of the questionnaire were approved. Patient education was determined by eight one-hour sessions over eight weeks. At the end of the education plan, the patients were given an educational booklet containing the main points of self-care for HD patients. The effectiveness of education plan was assessed two months after plan completion and data were compared with the pre-education scores. All analyses were conducted using the SPSS software (version 16) through descriptive and inferential statistics including correlation, t-test, ANOVA and ANCOVA tests. The results showed significant differences in the mean scores of physiological and self-concept models between the test and control groups (P = 0.01 and P = 0.03 respectively). Also a statistical difference (P = 0.04) was observed in the mean scores of the role function mode of both groups. There was no significant difference in the mean scores of interdependence modes between the two groups. RAM based patient education could improve the patients' adaptation in physiologic and self-concept modes. In addition to suggesting further research in this area, nurses are recommended to pay more attention in applying RAM in dialysis centers.

  13. Experiences of carrying out talking therapy in general practice: a qualitative interview study

    DEFF Research Database (Denmark)

    Davidsen, Annette Sofie

    2008-01-01

    OBJECTIVE: To explore GPs' experience of carrying out 'talking therapy'. METHODS: Qualitative study using semi-structured interviews with 11 Danish GPs sampled purposively. The material was analysed by Interpretative Phenomenological Analysis. RESULTS: The participants expressed difficulty...... developed over time, or more active therapeutic use of the relationship; (3) knowledge of the patient's life story, told or written, used to form a model of the patient's problems, thoughts and feelings. The sessions were not offered if the GPs lacked time. CONCLUSION: Participants were mostly self...

  14. The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

    Directory of Open Access Journals (Sweden)

    Mou’ath Hourani

    2016-06-01

    Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

  15. Simulations of Keratoconus Patient Vision with Optical Eye Modeling

    Science.gov (United States)

    Tan, Bo; Chen, Ying-Ling; Lewis, J. W. L.; Shi, Lei; Wang, Ming

    2007-11-01

    Keratoconus (KC) is an eye condition that involves progressive corneal thinning. Pushed by the intraocular pressure, the weakened cornea bulges outward and creates an irregular surface shape. The result is degraded vision that is difficult to correct with regular eye glasses or contact lens. In this study we use the optical lens design software, ZeMax, and patient data including cornea topography and refraction prescription to construct KC eye models. The variation of KC ``cone height'' on the cornea is used to simulate KC progression. The consequent patients' night vision and Snellen letter chart vision at 20 feet are simulated using these anatomically accurate 3-dimensional models. 100 million rays are traced for each image simulation. Animated results illustrate the change of KC visual acuity with the progression of disease. This simulation technique provides a comprehensive tool for medical training and patient consultation/education.

  16. Menu variations for diabetes mellitus patients using Goal Programming model

    Science.gov (United States)

    Dhoruri, Atmini; Lestari, Dwi; Ratnasari, Eminugroho

    2017-08-01

    Diabetes mellitus (DM) was a chronic metabolic disease characterized by higher than normal blood glucose level (normal blood glucose level = = 80 -120 mg/dl). In this study, type 2 DM which mostly caused by unhealthy eating habits would be investigated. Related to eating habit, DM patients needed dietary menu planning with an extracare regarding their nutrients intake (energy, protein, fat and carbohydrate). Therefore, the measures taken were by organizing nutritious dietary menu for diabetes mellitus patients. Dietary menu with appropriate amount of nutrients was organized by considering the amount of calories, proteins, fats and carbohydrates. In this study, Goal Programming model was employed to determine optimal dietary menu variations for diabetes mellitus patients by paying attention to optimal expenses. According to the data obtained from hospitals in Yogyakarta, optimal menu variations would be analyzed by using Goal Programming model and would be completed by using LINGO computer program.

  17. Reducing weapon-carrying among urban American Indian young people.

    Science.gov (United States)

    Bearinger, Linda H; Pettingell, Sandra L; Resnick, Michael D; Potthoff, Sandra J

    2010-07-01

    To examine the likelihood of weapon-carrying among urban American Indian young people, given the presence of salient risk and protective factors. The study used data from a confidential, self-report Urban Indian Youth Health Survey with 200 forced-choice items examining risk and protective factors and social, contextual, and demographic information. Between 1995 and 1998, 569 American Indian youths, aged 9-15 years, completed surveys administered in public schools and an after-school program. Using logistic regression, probability profiles compared the likelihood of weapon-carrying, given the combinations of salient risk and protective factors. In the final models, weapon-carrying was associated significantly with one risk factor (substance use) and two protective factors (school connectedness, perceiving peers as having prosocial behavior attitudes/norms). With one risk factor and two protective factors, in various combinations in the models, the likelihood of weapon carrying ranged from 4% (with two protective factors and no risk factor in the model) to 80% of youth (with the risk factor and no protective factors in the model). Even in the presence of the risk factor, the two protective factors decreased the likelihood of weapon-carrying to 25%. This analysis highlights the importance of protective factors in comprehensive assessments and interventions for vulnerable youth. In that the risk factor and two protective factors significantly related to weapon-carrying are amenable to intervention at both individual and population-focused levels, study findings offer a guide for prioritizing strategies for decreasing weapon-carrying among urban American Indian young people. Copyright (c) 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. Original article Rehabilitation model program for seriously ill patients

    Directory of Open Access Journals (Sweden)

    Adrienne Kegye

    2014-10-01

    Full Text Available Background Patients receiving cancer treatment start lifestyle changes mostly at the end of the treatment during the rehabilitation period. Most often, the first step is a dietary change and physical exercises built into the daily routine. Patients who do this in groups led by qualified therapists and based on professional counseling can build more effective and more permanent changes into their life. To develop a complex rehabilitation program which, in the short term, aims to familiarize patients with a lifestyle which harmonizes the physical, mental, spiritual and social spheres of life and, in the long term, to build it into their everyday life in order to ameliorate the physical and mental state and reduce the psychological symptoms and the isolation of patients. The physical component focuses on diet and exercise. The psycho-social-spiritual support focuses on discovering inner sources of strength, developing active coping mechanisms and helping to achieve more open communication. Participants and procedure In February and March 2011, 8 patients treated for malignant tumors participated in the model program. The components of the model program were psychotherapy, physiotherapy, cancer consultation, nutrition counseling, creative activities and walking. Results During the period of the model program the isolation of the patients decreased and their social support and ability of coping with the illness ameliorated. They reported an ease in anxiety and depression in their everyday activities. According to feedback, their communication with each other, with the staff and with their relatives became more open. Altogether this had advantageous effects on the functioning of the ward and the mood of the staff. Conclusions The rehabilitation program confirmed that beside individual psycho-social support, beneficial and economic psycho-social support can be provided for the patients in group form along with the most effective assignment of the

  19. Optimal growth trajectories with finite carrying capacity.

    Science.gov (United States)

    Caravelli, F; Sindoni, L; Caccioli, F; Ududec, C

    2016-08-01

    We consider the problem of finding optimal strategies that maximize the average growth rate of multiplicative stochastic processes. For a geometric Brownian motion, the problem is solved through the so-called Kelly criterion, according to which the optimal growth rate is achieved by investing a constant given fraction of resources at any step of the dynamics. We generalize these finding to the case of dynamical equations with finite carrying capacity, which can find applications in biology, mathematical ecology, and finance. We formulate the problem in terms of a stochastic process with multiplicative noise and a nonlinear drift term that is determined by the specific functional form of carrying capacity. We solve the stochastic equation for two classes of carrying capacity functions (power laws and logarithmic), and in both cases we compute the optimal trajectories of the control parameter. We further test the validity of our analytical results using numerical simulations.

  20. Optimal growth trajectories with finite carrying capacity

    Science.gov (United States)

    Caravelli, F.; Sindoni, L.; Caccioli, F.; Ududec, C.

    2016-08-01

    We consider the problem of finding optimal strategies that maximize the average growth rate of multiplicative stochastic processes. For a geometric Brownian motion, the problem is solved through the so-called Kelly criterion, according to which the optimal growth rate is achieved by investing a constant given fraction of resources at any step of the dynamics. We generalize these finding to the case of dynamical equations with finite carrying capacity, which can find applications in biology, mathematical ecology, and finance. We formulate the problem in terms of a stochastic process with multiplicative noise and a nonlinear drift term that is determined by the specific functional form of carrying capacity. We solve the stochastic equation for two classes of carrying capacity functions (power laws and logarithmic), and in both cases we compute the optimal trajectories of the control parameter. We further test the validity of our analytical results using numerical simulations.

  1. Carry Select Adder Circuit with A Successively Incremented Carry Number Block

    Directory of Open Access Journals (Sweden)

    Deepak

    2014-04-01

    Full Text Available This paper reports a conditional carry select (CCS adder circuit with a successively-incremented-carry-number block (SICNB structure for low-voltage VLSI implementation. Owing to the successively-incremented-carry-number block (SICNB structure, the new 16-bit SICNB CCS adder provides a 37% faster speed as compared to the conventional conditional Carry select adder based on the SPICE results

  2. Study on Tourist Carrying Capacity Based on Matter Element Analysis

    Institute of Scientific and Technical Information of China (English)

    LiuYunguo; FanTing; LiXin; ZhouMing; WangXianhai

    2005-01-01

    This paper proposes that it is necessary to implement the concept of tourist carrying capacity to facilitate the tourism planning, and presents a method to evaluate the carrying capacity. The method called matter element analysis can solve the uncertain and incompatible problem of the evaluated factors in assessing carrying capacity.The current state of a destination's carrying capacity can be determined by establishing the standard indexes and the matter element model. Through the evaluating of the travel industry zones of the Autonomous Prefecture of Western Hunan, the method is proved to be simple and feasible, and it is improved to be significant for the tourism planning and determination as well as the sustainable development of the regional tourism.

  3. An Optical Carry Chain Fast Adder

    Directory of Open Access Journals (Sweden)

    D. Al-Dabass

    1994-12-01

    Full Text Available A significant problem in Arithmetic Unit design and particularly for systolic arrays remains the speed attainable in achieving high speed addition. The root of the problem is carry propagation and a method is presented which is relatively independent of word length. The problem is addressed by the description of a suggested radical design involving a hybrid optical and electronic approach. The method of carry chain addition through pass gates is explained and a suggested implementation utilising Fabry-Perott resonators, optical waveguides and voltage controlled couplers is described. The design is suitable for n-stage modular expansion.

  4. Warfarin Dose Model for the Prediction of Stable Maintenance Dose in Indian Patients.

    Science.gov (United States)

    Gaikwad, Tejasvita; Ghosh, Kanjaksha; Avery, Peter; Kamali, Farhad; Shetty, Shrimati

    2017-01-01

    The main aim of this study was to screen various genetic and nongenetic factors that are known to alter warfarin response and to generate a model to predict stable warfarin maintenance dose for Indian patients. The study comprised of 300 warfarin-treated patients. Followed by extensive literature review, 10 single-nucleotide polymorphisms, that is, VKORC1-1639 G>A (rs9923231), CYP2C9*2 (rs1799853), CYP2C9*3 (rs1057910), FVII R353Q (rs6046), GGCX 12970 C>G (rs11676382), CALU c.*4A>G (rs1043550), EPHX1 c.337T>C (rs1051740), GGCX: c.214+597G>A (rs12714145), GGCX: 8016G>A (rs699664), and CYP4F2 V433M (rs2108622), and 5 nongenetic factors, that is, age, gender, smoking, alcoholism, and diet, were selected to find their association with warfarin response. The univariate analysis was carried out for 15 variables (10 genetic and 5 nongenetic). Five variables, that is, VKORC1-1639 G>A, CYP2C9*2, CYP2C9*3, age, and diet, were found to be significantly associated with warfarin response in univariate analysis. These 5 variables were entered in stepwise and multiple regression analysis to generate a prediction model for stable warfarin maintenance dose. The generated model scored R(2) of .67, which indicates that this model can explain 67% of warfarin dose variability. The generated model will help in prescribing more accurate warfarin maintenance dosing in Indian patients and will also help in minimizing warfarin-induced adverse drug reactions and a better quality of life in these patients.

  5. Just One Thing: a novel patient feedback model.

    Science.gov (United States)

    Gharib, I; Rolland, S L; Bateman, H; Ellis, J S

    2017-05-26

    In response to the Educational Standards of the UK's General Dental Council, Newcastle University, School of Dental Sciences introduced a patient feedback card to gather and incorporate patient feedback into their undergraduate assessment framework. The cards ask for patient response to two questions about their experience, and also ask patients to identify 'Just One Thing' (JOT) the student could do to improve this. JOT cards completed during a two week period were collected to evaluate and analyse the nature of patient responses within this model. Over 90% of JOT cards scored the students as 'Excellent' with the remainder scoring the student as 'Good' or giving no response. Many of the free text comments complimented the students and also provided focused suggestions for improvement. While the overwhelming positive responses may suggest that this model for collecting feedback may not be effective at discriminating between students with varying levels of interpersonal/communication skills, the free text comments were seen to be of value in building confidence or identifying areas for improvement.

  6. Increased carrying capacity with perennial forage kochia

    Science.gov (United States)

    Carrying capacity can be increased on grass-dominated rangeland pastures by including perennial forage kochia (Kochia prostrata) as one of the plant components. The objectives of the study reported here were to compare the differences of traditional winter pastures versus pastures with forage kochi...

  7. Locomotion while load-carrying in reduced gravities.

    Science.gov (United States)

    Wickman, L A; Luna, B

    1996-10-01

    Supporting the mass of a protective suit and portable life support system (PLSS) will impose an energy requirement on planetary astronauts. To design extravehicular protective equipment for planetary missions, scientists must learn more about human physical capabilities while load-carrying in reduced gravities. In this study, an underwater treadmill and weighting system were used to simulate reduced-gravity locomotion while load-carrying. The test matrix included 3 gravity levels, 6 subjects, 2 locomotion speeds, and a range of load sizes. Energy expenditure, calculated from measured oxygen consumption, is positively correlated with gravity level, speed, and load size. The data are used to project that individuals in average physical condition will be able to walk for 8 h on the Moon while carrying up to 170% of their body mass without undue fatigue, and on Mars with up to 50% of their body mass. These approximate limits, especially for Martian gravity, may prove quite a challenge for designers of advanced protective systems. Requirements for regenerable and non-venting PLSS components have been driving the total projected masses of advanced PLSSs increasingly higher, perhaps beyond what is reasonable to carry. However, the larger mass can be beneficial in maintaining bone mass. Using Whalen's model (1988), the daily planetary walking times required to maintain bone mass were calculated for a range of carried load sizes. The calculated times were unattainably high, suggesting that some combination of loads carrying and supplemental bone maintenance measures will likely be required to maintain bone mass in reduced gravity environments.

  8. Dataset in support of the generation of Niemann-Pick disease Type C1 patient-specific iPS cell lines carrying the novel NPC1 mutation c.1180T>C or the prevalent c.3182T>C mutation – Analysis of pluripotency and neuronal differentiation

    Directory of Open Access Journals (Sweden)

    Franziska Peter

    2017-06-01

    Full Text Available Data presented in this article demonstrate the generation and characterization of two novel Niemann-Pick disease Type C1 (NPC1 patient-specific induced pluripotent stem cell (iPSC lines, related to the research article Trilck et al. (Diversity of Glycosphingolipid GM2 and Cholesterol Accumulation in NPC1 Patient-Specific iPSC-Derived Neurons; Brain Res.; 2017; 1657:52-61. doi: 10.1016/j.brainres.2016.11.031. For reprogramming fibroblasts, carrying the novel homozygous mutation c.1180T>C and the prevalent homozygous mutation c.3182T>C, were used. Reprogramming into patient-specific iPSCs was induced by retroviral transduction of the transcription factors Sox2, Klf4, Oct4 and c-Myc, and confirmed according to their pluripotency. The iPSCs were subsequently differentiated into neural progenitor cells, which were terminally differentiated into functional neurons and glial cells. The generation of these cell lines provides further valuable tools to investigate pathogenic mechanism of NPC1 in human neuronal cells carrying different NPC1 mutations.

  9. Dataset in support of the generation of Niemann-Pick disease Type C1 patient-specific iPS cell lines carrying the novel NPC1 mutation c.1180T>C or the prevalent c.3182T>C mutation - Analysis of pluripotency and neuronal differentiation.

    Science.gov (United States)

    Peter, Franziska; Trilck, Michaela; Rabenstein, Michael; Rolfs, Arndt; Frech, Moritz J

    2017-06-01

    Data presented in this article demonstrate the generation and characterization of two novel Niemann-Pick disease Type C1 (NPC1) patient-specific induced pluripotent stem cell (iPSC) lines, related to the research article Trilck et al. (Diversity of Glycosphingolipid GM2 and Cholesterol Accumulation in NPC1 Patient-Specific iPSC-Derived Neurons; Brain Res.; 2017; 1657:52-61. doi: 10.1016/j.brainres.2016.11.031). For reprogramming fibroblasts, carrying the novel homozygous mutation c.1180T>C and the prevalent homozygous mutation c.3182T>C, were used. Reprogramming into patient-specific iPSCs was induced by retroviral transduction of the transcription factors Sox2, Klf4, Oct4 and c-Myc, and confirmed according to their pluripotency. The iPSCs were subsequently differentiated into neural progenitor cells, which were terminally differentiated into functional neurons and glial cells. The generation of these cell lines provides further valuable tools to investigate pathogenic mechanism of NPC1 in human neuronal cells carrying different NPC1 mutations.

  10. Object-oriented modeling of patients in a medical federation.

    Science.gov (United States)

    Proctor, M D; Creech, G S

    2001-09-01

    This research explores the development of an object-oriented model to support inter-operation of simulations within a federation for the purpose of conducting medical analysis and training over a distributed infrastructure. The medical federation is referred to as the combat trauma patient simulation system and is composed using high level architecture. The infrastructure contains components that were separately developed and are heterogeneous in nature. This includes a general anatomical computer database capable of generating human injuries, referred to as operational requirements-based casualty assessment, an animated mannequin called the human patient simulator, and other components. The research develops an object model that enables bodily injury data to be shared across the simulation, conducts analysis on that data, and considers possible applications of the technique in expanded medical infrastructures.

  11. Proof-Carrying Code with Correct Compilers

    Science.gov (United States)

    Appel, Andrew W.

    2009-01-01

    In the late 1990s, proof-carrying code was able to produce machine-checkable safety proofs for machine-language programs even though (1) it was impractical to prove correctness properties of source programs and (2) it was impractical to prove correctness of compilers. But now it is practical to prove some correctness properties of source programs, and it is practical to prove correctness of optimizing compilers. We can produce more expressive proof-carrying code, that can guarantee correctness properties for machine code and not just safety. We will construct program logics for source languages, prove them sound w.r.t. the operational semantics of the input language for a proved-correct compiler, and then use these logics as a basis for proving the soundness of static analyses.

  12. Computer Simulation Instruction: Carrying out Chemical Experiments

    Directory of Open Access Journals (Sweden)

    Ibtesam Al-Mashaqbeh

    2014-05-01

    Full Text Available The purpose of this study was to investigate the effect of computer simulation Instruction (CSI on students' achievements: Carrying out chemical experiments to acquire chemical concepts for eleventh grade students. The subject of the study consisted two sections of a one girl's high school in Jordan. One section was randomly assigned to experimental group in which computer simulation Instruction (CSI was used, and the other section was randomly assigned to control group in which students were instructed by using the traditional teaching instruction. The findings indicated that there is progress on the part of the experimental group which used the computer simulation Instruction (CSI and this was reflected positively in the students’ achievement in carrying out chemical experiments to acquire chemical concepts.

  13. A decimal carry-free adder

    Science.gov (United States)

    Nikmehr, Hooman; Phillips, Braden; Lim, Cheng-Chew

    2005-02-01

    Recently, decimal arithmetic has become attractive in the financial and commercial world including banking, tax calculation, currency conversion, insurance and accounting. Although computers are still carrying out decimal calculation using software libraries and binary floating-point numbers, it is likely that in the near future, all processors will be equipped with units performing decimal operations directly on decimal operands. One critical building block for some complex decimal operations is the decimal carry-free adder. This paper discusses the mathematical framework of the addition, introduces a new signed-digit format for representing decimal numbers and presents an efficient architectural implementation. Delay estimation analysis shows that the adder offers improved performance over earlier designs.

  14. Like an eagle carries its young

    Directory of Open Access Journals (Sweden)

    Hans-Georg Wünch

    2016-04-01

    Full Text Available The picture of an eagle carrying its young on its wings (Dt 32:11 is a powerful and encouraging image of trust and security in God. It is particularly relevant for Western culture, where the eagle is a prominent symbol of power and strength. In recent years, though, the translation of the Hebrew term רֶשֶׁנ as ‘eagle’ has come into question and modern exegetes claim that it is more accurately translated as ‘vulture’. But can this really be a symbol of comfort? Furthermore, do eagles (or vultures even carry their young on their wings? This article intends to shed some light on these questions.Keywords: Old Testament; Deuteronomy; Eagle; Vulture

  15. A Feminist Reading of Sister Carrie

    Institute of Scientific and Technical Information of China (English)

    Wang; Jiatong

    2015-01-01

    In the history of American literature,Sister Carrie is the first novel of Theodore Dreiser,it impresses people deeply.Carrie,a poor country girl,becomes a famous star in a big city.She has totally changed from her hard experiences,and she becomes financially independent as a new woman when she goes through hesitation.In he whole novel,the author has planted some strong points of Carrie’s character.At the end of this paper,it analyzes woman’s status in modern time from two aspects of the improvement of female’s social status and the comparison between men and women.

  16. A Predictive Model for Massive Transfusion in Combat Casualty Patients

    Science.gov (United States)

    2008-02-01

    A Predictive Model for Massive Transfusion in Combat Casualty Patients Daniel F . McLaughlin, MD, Sarah E. Niles, MD, MPH, Jose Salinas, PhD, Jeremy G...Silver Springs, Maryland. Address for reprints: Daniel F . McLaughlin, MD, United States Insti- tute of Surgical Research, 3400 Rawley E. Chambers...see that here? Thank you again for an excellent study, which I believe should alter practice for many of us. Dr. Daniel F . McLaughlin (US Army

  17. Pilot Study of a Patient-Centered Radiology Process Model.

    Science.gov (United States)

    Swan, J Shannon; Furtado, Vanessa F; Keller, Lisa A; Lotti, Judith Borsody; Saltalamacchia, Catherine A; Lennes, Inga T; Salazar, Gloria M

    2017-02-01

    The Radiology Process Model (RPM) was previously described in terms of its conceptual basis and proposed survey items. The current study describes the first pilot application of the RPM in the field and the results of initial psychometric analysis. We used an Institutional Review Board-approved pilot RPM survey in 100 patients having outpatient interventional radiology procedures. The 24 survey items had 4 or 5 levels of severity. We assessed for missing data, items that patients found confusing, any suggestions by patients for additional items and clarity of items from patient feedback. Factor analysis was performed and internal consistency measured. Construct validity was assessed by correlation of patient responses to the items as a summated scale with a visual analog scale (VAS) they completed indicating their interventional radiology experience. The visual analog scale and the RPM summated scale were strongly correlated (r = 0.7). Factor analysis showed four factors: interactions with facility and doctors/staff, time-sensitive aspects, pain, and anxiety. The items showed high internal consistency (alpha: 0.86) as a group and approximately 0.7 to 0.9 by the factors. Analysis shows that two items could be deleted (cost and communication between radiologist and referrers). Revision of two items and potential addition of others are discussed. The RPM shows initial evidence of psychometric validity and internal consistency reliability. Minor changes are anticipated before wider use. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Influence of age and sex on pharmacodynamics of propofol in neurosurgical patients: model development

    Institute of Scientific and Technical Information of China (English)

    Yu-hong LI; Fu-sheng WU; Jian-guo XU

    2006-01-01

    Aim: To determine propofol concentration in the cerebral spinal fluid (CSF) of neurosurgical patients and carry out a preliminary population pharmacodynamic study. Methods: Twenty-seven elective neurosurgical patients (12 men and 15 women) aged 17-74 years received propofol in a bolus dose of 2 mg/kg for 5 min and an infusion of 10 mg/kg per h for 5 min. Frequent CSF samples were drawn and assayed for propofol concentration. The bispectral index (BIS) was used to measure the drug effect. All data were analyzed first with the Excel software package, then pharmacodynamics modeling was performed using the NONMEM software package. Results: The CSF concentration was related to the drug effect with linear and sigmoid Emax models. The parameters for the linear addictive model were a= 1.11 and b=95.4. The parameters for the linear exponential model were a= 1.05 and b=92.7. The parameters for the sigmoid Emax model were Emax=119, EC50= 53.6 ng/Ml, and W=1.51. When the covariates of age, weight and sex were considered, the parameters of models, objective function, the standard error of the mean and the prediction error were not optimized. Conclusion: Linear additive, linear exponential and sigmoid Emax models can be used to describe the pharmacodynamics of propofol with respect to the concentration in CSF. In this small population, age (17-74 years), weight (47-98 kg) and sex did not influence any of the pharmacodynamic parameters of propofol. To verify these preliminary results, a larger study population is required.

  19. A mathematical prognosis model for pancreatic cancer patients receiving immunotherapy.

    Science.gov (United States)

    Li, Xuefang; Xu, Jian-Xin

    2016-10-07

    Pancreatic cancer is one of the most deadly types of cancer since it typically spreads rapidly and can seldom be detected in its early stage. Pancreatic cancer therapy is thus a challenging task, and appropriate prognosis or assessment for pancreatic cancer therapy is of critical importance. In this work, based on available clinical data in Niu et al. (2013) we develop a mathematical prognosis model that can predict the overall survival of pancreatic cancer patients who receive immunotherapy. The mathematical model incorporates pancreatic cancer cells, pancreatic stellate cells, three major classes of immune effector cells CD8+ T cells, natural killer cells, helper T cells, and two major classes of cytokines interleukin-2 (IL-2) and interferon-γ (IFN-γ). The proposed model describes the dynamic interaction between tumor and immune cells. In order for the model to be able to generate appropriate prognostic results for disease progression, the distribution and stability properties of equilibria in the mathematical model are computed and analysed in absence of treatments. In addition, numerical simulations for disease progression with or without treatments are performed. It turns out that the median overall survival associated with CIK immunotherapy is prolonged from 7 to 13months compared with the survival without treatment, this is consistent with the clinical data observed in Niu et al. (2013). The validity of the proposed mathematical prognosis model is thus verified. Our study confirms that immunotherapy offers a better prognosis for pancreatic cancer patients. As a direct extension of this work, various new therapy methods that are under exploration and clinical trials could be assessed or evaluated using the newly developed mathematical prognosis model.

  20. Dialectical Examination about Carrying out the Teaching Model of“Flipped Classroom”in Higher Vocational Education%高职开展“Flipped Classroom”教学模式的辩证审视

    Institute of Scientific and Technical Information of China (English)

    吴一凡

    2014-01-01

    翻转课堂(Flipped Classroom)作为一种新型的教学模式,在高职教育中同样具有可操作性。从高等职业教育的角度出发,在翻转课堂教学模式的背景及其基本概念的基础上,对高职校园外在环境、课程的适应性、实施前提条件、课堂教学质量等四个方面对实施翻转课堂教学模式进行辨证的审视。%Flipped Classroom, which is a new teaching model, is operable in higher vocational education. From the perspective of higher vocational education, this paper dialectically examines the outside environment of higher vocational colleges, the adaptability of curriculum, the preconditions of this model, and the quality of classroom teaching based on the background of flipped classroom and its basic concept.

  1. Information carrying capacity of a cosmological constant

    Science.gov (United States)

    Simidzija, Petar; Martín-Martínez, Eduardo

    2017-01-01

    We analyze the exchange of information in different cosmological backgrounds when sender and receiver are timelike separated and communicate through massless fields (without the exchange of light signals). Remarkably, we show that the dominance of a cosmological constant makes the amount of recoverable information imprinted in the field by the sender extremely resilient: it does not decay in time or with the spatial separation of the sender and receiver, and it actually increases with the rate of expansion of the Universe. This is in stark contrast with the information carried by conventional light signals and with previous results on timelike communication through massless fields in matter-dominated cosmologies.

  2. MODELING CHRONIC DISEASE PATIENT FLOWS DIVERTED FROM EMERGENCY DEPARTMENTS TO PATIENT-CENTERED MEDICAL HOMES.

    Science.gov (United States)

    Diaz, Rafael; Behr, Joshua; Kumar, Sameer; Britton, Bruce

    Chronic Disease is defined as a long lasting health condition, which can develop and/or worsen over an extended time, but which can also be controlled. The monetary and budgetary toll due to its persistent nature has become unsustainable and requires pressing actions to limit their incidence and burden. This paper demonstrates the utility of the System Dynamics approach to simulate the behavior of key factors involved in the implementation of chronic disease management. We model the patient flow diversion from emergency departments (ED) to patient-centered medical homes (PCMH), with emphasis on the visit rates, as well as the effect of insurance coverage, in an effort to assure continuity of quality care for Asthma patients at lower costs. The model is used as an evaluative method to identify conditions of a maintained health status through adequate policy planning, in terms of resources and capacity. This approach gives decision makers the ability to track the level of implementation of the intervention and generate knowledge about dynamics between population demands and the intervention effectiveness. The functionality of the model is demonstrated through the consideration of hypothetical scenarios executed using sensitivity analysis.

  3. A Causal Model for Fluctuating Sugar Levels in Diabetes Patients

    Directory of Open Access Journals (Sweden)

    Kinzang Chhogyal

    2012-09-01

    Full Text Available Background Causal models of physiological systems can be immensely useful in medicine as they may be used for both diagnostic and therapeutic reasoning. Aims In this paper we investigate how an agent may use the theory of belief change to rectify simple causal models of changing blood sugar levels in diabetes patients. Method We employ the semantic approach to belief change together with a popular measure of distance called Dalal distance between different state descriptions in order to implement a simple application that simulates the effectiveness of the proposed method in helping an agent rectify a simple causal model. Results Our simulation results show that distance-based belief change can help in improving the agent’s causal knowledge. However, under the current implementation there is no guarantee that the agent will learn the complete model and the agent may at times get stuck in local optima. Conclusion Distance-based belief change can help in refining simple causal models such as the example in this paper. Future work will include larger state-action spaces, better distance measures and strategies for choosing actions.

  4. Predictors of Weapon Carrying in Youth Attending Drop-in Centers

    Science.gov (United States)

    Blumberg, Elaine J.; Liles, Sandy; Kelley, Norma J.; Hovell, Melbourne F.; Bousman, Chad A.; Shillington, Audrey M.; Ji, Ming; Clapp, John

    2009-01-01

    Objective: To test and compare 2 predictive models of weapon carrying in youth (n=308) recruited from 4 drop-in centers in San Diego and Imperial counties. Methods: Both models were based on the Behavioral Ecological Model (BEM). Results: The first and second models significantly explained 39% and 53% of the variance in weapon carrying,…

  5. Pallet Optimization of the Heavy Rotary Table Load Carrying System

    Science.gov (United States)

    Atapin, V. G.; Bataev, A. A.

    2016-04-01

    The pallet optimization of the heavy rotary table load-carrying system, which is a part of the multi-purpose machine, is considered in terms of the deterministic and probabilistic models. As a result of optimum design in case of the deterministic model the mass of the pallet is reduced by 35.5 % in comparison with a serial model. The evaluation of the influence of optimization problem limitations on design variables confirms the importance of rigidity criterion in relation to other criteria. Calculation for probabilistic model allows reducing the mass of the construction by 27 % in comparison with the deterministic model. Considering a work piece rigidity on the basis of a conventional work piece of the minimum rigidity (without stiffening ribs etc.) leads to reducing of the pallet mass by 22.3 % in comparison with the deterministic model.

  6. A C-Testable Multiple-Block Carry Select Adder

    Science.gov (United States)

    Kito, Nobutaka; Fujii, Shinichi; Takagi, Naofumi

    We propose a C-testable multiple-block carry select adder with respect to the cell fault model. Full adders and 2: 1 multiplexers are considered as cells. By an additional external input, we obtain a C-testable carry select adder. We only modify the least significant position of each block. The adder is testable with a test set consisting of 16 patterns regardless of the size of each block and the number of blocks. This is the minimum test set for the adder. We show two gate-level implementations of the adder which are testable with a test set of 9 patterns and 7 patterns respectively, with respect to the single stuck-at fault model.

  7. Modeling impulsivity in forensic patients: A three-dimensional model of impulsivity

    NARCIS (Netherlands)

    Tonnaer, F.; Cima, M.; Arntz, A.R.

    2016-01-01

    The current study investigated whether a multidimensional model could underlie impulsivity and its associations with various disorders in a forensic sample. Data were available from self-report and behavioral impulsivity instruments of 87 forensic patients. Principal component analysis (PCA) was use

  8. DESIGN OF OPTIMAL CARRY SKIP ADDER AND CARRY SKIP BCD ADDER USING REVERSIBLE LOGIC GATES

    OpenAIRE

    Praveena Murugesan; Thanushkodi Keppanagounder

    2014-01-01

    Reversible logic circuits have the ability to produce zero power dissipation which has found its importance in quantum computing, optical computing and low power digital circuits. The study presents improved and efficient reversible logic circuits for carry skip adder and carry skip BCD adder. The performance of the proposed architecture is better than the existing works in terms of gate count, garbage outputs and constant inputs. This design forms the basis for different quantum ALU and embe...

  9. Self-timed Manchester chain carry propagate adder

    OpenAIRE

    Escribà, J; Carrasco, Juan A.

    1996-01-01

    The authors present a self-timed adder that uses two Manchester chains to propagate carries in a two-rail code. With the inclusion of buffers in the chains, the adder meets the timing conditions typical of an asynchronous design based in the ‘bundled-data, bounded-delay’ model and is signifcantly faster than self-timed adders with restoring logic and similar complexity.

  10. Different Ways of Carrying Bags in Mental Retarded Students

    Directory of Open Access Journals (Sweden)

    Saideh-Sadat Mortazavi

    2012-10-01

    Full Text Available School as an educational and social center is linked with various aspects of child’s growth. The impact of objects, tools, and lifestyle on the development of human performance is not hidden from anyone [1].Tasell Lauri, the head of Cairo Praktive in Australia, in a paper warned parents about bags as a tool that students carry every day, and he is believes that many spinal disorders in adults is caused by childhood trauma. Studies on children and patients with special needs and such as myelomenangocele, cerebral palsy, and neurofibromatosis precisely show abnormal growth of spinal disorders, muscle imbalance, wrong posture [2]. Carrying stationery in an inappropriate tool can cause irreversible effects.

  11. Modelling a Parasystolic Rhythm in a Heart Transplanted Patient

    CERN Document Server

    Costa, M; Santiago, T; Rebocho, M J; Melo, J; Ducla-Soares, E; Santiago, Teresa

    1999-01-01

    A parasystole from a heart transplanted patient was analysed via the beat to beat - RR interval time series obtained from the electrocardiogram (ECG). The dysrhythmia, resulting from the coexistence of two pacemakers, the sinus node and an ectopic focus, presents distinctive regular patterns with transitions from one pattern to another occurring abruptly. It is shown that the parasystolic rhythm can be simulated by a model involving two oscillators firing at fixed rates, under the restriction that neither is allowed to fire during the other's refractory period. We found that the structure of the generated RR time series is essentially determined by the ratio of the period of the two oscillators. In the case of the heart transplanted patient that has a small heart rate variability as a result of heart denervation, the model could predict the sequence of RR intervals over a considerable period of time (~ 80 beats with an error < 6%). From a physiological point of view, our results imply that the interaction ...

  12. Retinal oscillations carry visual information to cortex

    Directory of Open Access Journals (Sweden)

    Kilian Koepsell

    2009-04-01

    Full Text Available Thalamic relay cells fire action potentials that transmit information from retina to cortex. The amount of information that spike trains encode is usually estimated from the precision of spike timing with respect to the stimulus. Sensory input, however, is only one factor that influences neural activity. For example, intrinsic dynamics, such as oscillations of networks of neurons, also modulate firing pattern. Here, we asked if retinal oscillations might help to convey information to neurons downstream. Specifically, we made whole-cell recordings from relay cells to reveal retinal inputs (EPSPs and thalamic outputs (spikes and then analyzed these events with information theory. Our results show that thalamic spike trains operate as two multiplexed channels. One channel, which occupies a low frequency band (<30 Hz, is encoded by average firing rate with respect to the stimulus and carries information about local changes in the visual field over time. The other operates in the gamma frequency band (40-80 Hz and is encoded by spike timing relative to retinal oscillations. At times, the second channel conveyed even more information than the first. Because retinal oscillations involve extensive networks of ganglion cells, it is likely that the second channel transmits information about global features of the visual scene.

  13. Testability Synthesis for Jumping Carry Adders

    Directory of Open Access Journals (Sweden)

    Chien-In Henry Chen

    2002-01-01

    Full Text Available Synthesis for testability ensures that the synthesized circuit is testable by exploring the fundamental relationship between don't care and redundancy. With the exploration of the relationship, redundancy removal can be applied to improve the testability, reduce the area and improve the speed of a synthesized circuit. The test generation problems have been adequately solved, therefore an innovative testability synthesis strategy is necessary for achieving the maximum fault coverage and area reduction for maximum speed. This paper presents a testability synthesis methodology applicable to a top–down design method based on the identification and removal of redundant faults. Emphasis has been placed on the testability synthesis of a high-speed binary jumping carry adder. A synthesized 32-bit testable adder implemented by a 1.2 μm CMOS technology performs addition in 4.09 ns. Comparing with the original synthesized circuit, redundancy removal yields a 100% testable design with a 15% improvement in speed and a 25% reduction in area.

  14. Robust ferromagnetism carried by antiferromagnetic domain walls

    Science.gov (United States)

    Hirose, Hishiro T.; Yamaura, Jun-Ichi; Hiroi, Zenji

    2017-02-01

    Ferroic materials, such as ferromagnetic or ferroelectric materials, have been utilized as recording media for memory devices. A recent trend for downsizing, however, requires an alternative, because ferroic orders tend to become unstable for miniaturization. The domain wall nanoelectronics is a new developing direction for next-generation devices, in which atomic domain walls, rather than conventional, large domains themselves, are the active elements. Here we show that atomically thin magnetic domain walls generated in the antiferromagnetic insulator Cd2Os2O7 carry unusual ferromagnetic moments perpendicular to the wall as well as electron conductivity: the ferromagnetic moments are easily polarized even by a tiny field of 1 mT at high temperature, while, once cooled down, they are surprisingly robust even in an inverse magnetic field of 7 T. Thus, the magnetic domain walls could serve as a new-type of microscopic, switchable and electrically readable magnetic medium which is potentially important for future applications in the domain wall nanoelectronics.

  15. Models for patients' recruitment in clinical trials and sensitivity analysis.

    Science.gov (United States)

    Mijoule, Guillaume; Savy, Stéphanie; Savy, Nicolas

    2012-07-20

    Taking a decision on the feasibility and estimating the duration of patients' recruitment in a clinical trial are very important but very hard questions to answer, mainly because of the huge variability of the system. The more elaborated works on this topic are those of Anisimov and co-authors, where they investigate modelling of the enrolment period by using Gamma-Poisson processes, which allows to develop statistical tools that can help the manager of the clinical trial to answer these questions and thus help him to plan the trial. The main idea is to consider an ongoing study at an intermediate time, denoted t(1). Data collected on [0,t(1)] allow to calibrate the parameters of the model, which are then used to make predictions on what will happen after t(1). This method allows us to estimate the probability of ending the trial on time and give possible corrective actions to the trial manager especially regarding how many centres have to be open to finish on time. In this paper, we investigate a Pareto-Poisson model, which we compare with the Gamma-Poisson one. We will discuss the accuracy of the estimation of the parameters and compare the models on a set of real case data. We make the comparison on various criteria : the expected recruitment duration, the quality of fitting to the data and its sensitivity to parameter errors. We discuss the influence of the centres opening dates on the estimation of the duration. This is a very important question to deal with in the setting of our data set. In fact, these dates are not known. For this discussion, we consider a uniformly distributed approach. Finally, we study the sensitivity of the expected duration of the trial with respect to the parameters of the model : we calculate to what extent an error on the estimation of the parameters generates an error in the prediction of the duration.

  16. The effect of improving the satisfaction of hospitalized patients care by carrying out high quality nursing service in remote mountainous areas%边远山区医院开展优质护理服务对患者护理满意度的影响

    Institute of Scientific and Technical Information of China (English)

    鲍宁华; 兰芸

    2013-01-01

    Objective Discuss the effect of improving the satisfaction of hospitalized patients care by carrying out high quality nursing ser-vice in remote mountainous areas. Methods Investigate care satisfaction of 1634 hospitalized patients in our hospital from 2010 July to September, and compare the care satisfaction between hospitalized patients who have received high quality nursing service (observed group) as well as who haven't (contractive group). Results The care services satisfaction of observed group inpatient was 90.75%, the contrastive group was 79.87%. Observed group was 10.88% higher than the contractive group. There are significant differences between the two group (P<0.05). Conclusion Carrying out high quality nursing service can effectively improve the relationship between nurses and patients, improve the care quality and significantly improve inpatient satisfaction.%目的探讨在边远山区开展优质护理服务对提高住院患者护理满意度的效果。方法对住院治疗的1634例患者进行护理满意度调查,比较开展优质护理服务病房患者(观察组)和未开展优质护理服务病房患者(对照组)的满意度。结果观察组住院患者护理服务满意度为90.75%,对照组满意度为79.87%,观察组比对照组高10.88%,两组差异有统计学意义(P<0.05)。结论开展优质护理服务能有效改善护患关系,提高护理质量,显著提升住院患者满意度。

  17. Efficient carry skip Adder design using full adder and carry skip block based on reversible Logic

    Directory of Open Access Journals (Sweden)

    Varun Pratap Singh

    2015-12-01

    Full Text Available In recent years, Reversible Logic is becoming more and more prominent technology having its applications in Quantum Computing, Nanotechnology, and Optical Computing. Reversibility plays an important role when energy efficient computations are considered. In this paper, binary full Adder with Design I and Design II are proposed. The performance analysis is verified using number of reversible gates, Garbage input/outputs, delay, number of logical calculations and Quantum Cost. According to the suitability of full adder design I and design II carry skip adder block is also constructed with some improvement in terms of delay in block carry generation. It is observed that Reversible carry skip Binary Adder with Design II is efficient compared to Design I

  18. When to carry out analytic continuation?

    CERN Document Server

    Zuo, J M

    1998-01-01

    This paper discusses the analytic continuation in the thermal field theory by using the theory of $\\eta-\\xi$ spacetime. Taking a simple model as example, the $2\\times 2$ matrix real-time propagator is solved from the equation obtained through continuation of the equation for the imaginary-time propagator. The geometry of the $\\eta-\\xi$ spacetime plays important role in the discussion.

  19. Factors affecting patients' online health information-seeking behaviours: The role of the Patient Health Engagement (PHE) Model.

    Science.gov (United States)

    Graffigna, Guendalina; Barello, Serena; Bonanomi, Andrea; Riva, Giuseppe

    2017-10-01

    To identify the variables affecting patients' online health information-seeking behaviours by examining the relationships between patient participation in their healthcare and online health information-seeking behaviours. A cross-sectional survey of Italian chronic patients (N=352) was conducted on patient's online health information-seeking behaviours and patient participation-related variables. Structural equation modeling analysis was conducted to test the hypothesis. This study showed how the healthcare professionals' ability to support chronic patients' autonomy affect patients' participation in their healthcare and patient's online health information-seeking behaviours. However, results do not confirm that the frequency of patients' online health-information seeking behavior has an impact on their adherence to medical prescriptions. Assuming a psychosocial perspective, we have discussed how patients' engagement - conceived as the level of their emotional elaboration of the health condition - affects the patients' ability to search for and manage online health information. To improve the effectiveness of patients' online health information-seeking behaviours and to enhance the effectiveness of technological interventions in this field, healthcare providers should target assessing and improving patient engagement and patient empowerment in their healthcare. It is important that health professionals acknowledge patients' online health information-seeking behaviours that they discuss the information offered by patients and guide them to reliable and accurate web sources. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Radial excitations of current-carrying vortices

    Science.gov (United States)

    Hartmann, Betti; Michel, Florent; Peter, Patrick

    2017-04-01

    We report on the existence of a new type of cosmic string solutions in the Witten model with U (1) × U (1) symmetry. These solutions are superconducting with radially excited condensates that exist for both gauged and ungauged currents. Our results suggest that these new configurations can be macroscopically stable, but microscopically unstable to radial perturbations. Nevertheless, they might have important consequences for the network evolution and particle emission. We discuss these effects and their possible signatures. We also comment on analogies with non-relativistic condensed matter systems where these solutions may be observable.

  1. Multiscale modeling and surgical planning for single ventricle heart patients

    Science.gov (United States)

    Marsden, Alison

    2011-11-01

    Single ventricle heart patients are among the most challenging for pediatric cardiologists to treat, and typically undergo a palliative course of three open-heart surgeries starting immediately after birth. We will present recent tools for modeling blood flow in single ventricle heart patients using a multiscale approach that couples a 3D Navier-Stokes domain to a 0D closed loop lumped parameter network comprised of circuit elements. This coupling allows us to capture the effect of changes in local geometry, such as shunt sizes, on global circulatory dynamics, such as cardiac output. A semi-implicit numerical method is formulated to solve the coupled system in which flow and pressure information is passed between the two domains at the inlets and outlets of the model. A finite element method with outflow stabilization is applied in the 3D Navier-Stokes domain, and the LPN system of ordinary differential equations is solved numerically using a Runge-Kutta method. These tools are coupled via automated scripts to a derivative-free optimization method. Optimization is used to systematically explore surgical designs using clinically relevant cost functions for two stages of single ventricle repair. First, we will present results from optimization of the first stage Blalock Taussig Shunt. Second, we will present results from optimization of a new Y-graft design for the third stage of single ventricle repair called the Fontan surgery. The Y-graft is shown, in simulations, to successfully improve hepatic flow distribution, a known clinical problem. Preliminary clinical experience with the Y-graft will be discussed.

  2. Patient satisfaction and organizational impact: a hierarchical linear modeling approach.

    Science.gov (United States)

    Otani, Koichiro; Kim, B Joon; Waterman, Brian; Boslaugh, Sarah; Klinkenberg, W Dean; Dunagan, W Claiborne

    2012-01-01

    This article presents the rationale for using multilevel analysis to address the broad environmental contexts in patient satisfaction research. This study utilized patient satisfaction data and the American Hospital Association Hospital Guide Book (2004). This study found significant contributions of individual patient attribute reactions (nursing care, physician care, etc.), and also clearly demonstrated hospital-level effects and cross-level interactions on patient satisfaction. Thus, it is clear that patient satisfaction is not solely explained by patients' attribute reactions and their demographic variables, but is also explained by patients' hospital levels. This approach would offer additional understanding in patient satisfaction research.

  3. How patients choose hospitals: using the stereotypic content model to model trustworthiness, warmth and competence.

    Science.gov (United States)

    Drevs, Florian

    2013-08-01

    In many countries, policy initiatives force the implementation of demand-driven healthcare systems to encourage competition among providers. When actively choosing hospitals, consumers can compare data on the quality of hospital performance among providers. However, patients do not necessarily take full advantage of comparative quality information but instead use a number of readily available proxies to evaluate provider trustworthiness. According to the stereotypic content model, organizational trustworthiness is built on stereotypical perceptions of hospitals' competence and warmth, reflected by visible hospital characteristics such as ownership and teaching status, and size. We introduce a theoretical framework on stereotypic quality perceptions that brings together fragmented findings in health services research on patient quality expectations of hospital characteristics. The model provides a basis for further research and recommendations for improved hospital communication strategies. The study suggests that researchers as well as hospital management should pay more attention to stereotypical patient quality perceptions and their impact on hospital choice to understand patients' quality evaluations better. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  4. Usage of a homemade audiovisual disc carrying rehabilitation contents to guide post-stroke hemiplegia patients to do functional exercises of shoulder joints%应用康复教育光碟指导脑卒中偏瘫患者肩关节功能锻炼

    Institute of Scientific and Technical Information of China (English)

    石翠霞; 唐文明; 和中月; 杨艳玲; 崔彩虹

    2013-01-01

    Objective To investigate the effect of applying a homemade audiovisual disc carrying rehabilitation contents to post-stroke hemiplegia patients for functional exercise of the shoulder joints.Methods A controlled study design was made to divide 65 poststroke hemiplegia patients into a control group of 33 and an observation group of 32.The control group were instructed to do conventional rehabilitation training,while the observation group additionally were instructed to watch a homemade audiovisual disc carrying rehabilitation contents prior to rehabilitation training.Incidence rates of shoulder joint subluxation,and compliance rates to rehab,between the 2 groups were compared.The upper extremities motor function of the 2 groups was evaluated using the FuglMeyer Assessment (FMA).Results There were significant differences in the incidence rates of the shoulder subluxation,the compliance rates to rehab,and the upper extremities motor function scores between the 2 groups after 2 months (P<0.05,P<0.01).Conclusion Watching the audiovisual disc carrying rehabilitation contents,could stimulate hemiplegia patients' desire for rehabilitation,improve their upper extremities motor function,and reduce the incidence rates of shoulder joints subluxation,and therefore,boost rehabilitation of patients.%目的 探讨应用康复教育光碟指导脑卒中偏瘫患者肩关节功能锻炼的效果.方法 将65例康复治疗的脑卒中偏瘫患者按照时间顺序分为对照组(n=33)与观察组(n=32),对照组接受康复训练治疗,观察组在观看康复教育光碟示范下行康复训练治疗.比较两组患者肩关节半脱位发生率及康复训练依从率,并采用Fugl-Meyer评分法(FMA)评定两组患者上肢运动功能.结果 康复训练2个月后观察组肩关节半脱位发生率、康复训练依从率、上肢FMA评分与对照组比较,差异有统计学意义(P<0.05,P<0.01).结论 观看康复教育光碟可激发患者的康复欲望,提高上

  5. Efficient Approaches for Designing Fault Tolerant Reversible Carry Look-Ahead and Carry-Skip Adders

    CERN Document Server

    Islam, Md Saiful; begum, Zerina; Hafiz, Mohd Zulfiquar

    2010-01-01

    Combinational or Classical logic circuits dissipate heat for every bit of information that is lost. Information is lost when the input vector cannot be recovered from its corresponding output vector. Reversible logic circuit implements only the functions having one-to-one mapping between its input and output vectors and therefore naturally takes care of heating. Reversible logic design becomes one of the promising research directions in low power dissipating circuit design in the past few years and has found its application in low power CMOS design, digital signal processing and nanotechnology. This paper presents the efficient approaches for designing fault tolerant reversible fast adders that implement carry look-ahead and carry-skip logic. The proposed high speed reversible adders include MIG gates for the realization of its basic building block. The MIG gate is universal and parity preserving. It allows any fault that affects no more than a single signal readily detectable at the circuit's primary outputs...

  6. Gquest: modeling patient questionnaires and administering them through a mobile platform application.

    Science.gov (United States)

    Lanzola, G; Ginardi, M G; Mazzanti, A; Quaglini, S

    2014-11-01

    The use of surveys is becoming popular in the health care industry for acquiring information useful to the accomplishment of several studies. Besides their exploitation on a large scale for conducting epidemiological studies, surveys are being increasingly carried out on a narrower perspective through the administration of questionnaires aimed at assessing the quality of life perceived by patients or their clinical status during mid- or long-term treatments. This is useful for managing resources or optimizing and individualizing treatments. This paper describes Gquest, a platform for modeling, generating and administering questionnaires through mobile devices such as smartphones or tablets. Gquest was motivated by the need of administering questionnaires during home treatments, albeit its applicability is rather general. The main requirement was to have a very simple, clean and easy to use platform able to support (a) physicians in the design and delivery of questionnaires and (b) outpatients in sending self-recorded outcomes to the clinical staff. Gquest has two basic components. The first one is a model devised for representing questionnaires which is extremely flexible. It allows the generation of questions and answers of different types, supports adaptivity in the dialog with the user and enforces simple consistency rules for checking his input. The second component is an application able to run instances of those questionnaires. It downloads questionnaires over the air in terms of XML files from a server and stores them locally into the mobile repository. Questionnaires become then available to the user, who in our case is a patient or one of his relatives. The user can select which one to fill-in, according to his needs and/or the specific treatment protocol. The selected questionnaire may be filled-in all at once or be completed in subsequent steps over time since any input provided is persisted on a local database. Finally, when a questionnaire is closed

  7. Multistate Statistical Modeling: A Tool to Build a Lung Cancer Microsimulation Model That Includes Parameter Uncertainty and Patient Heterogeneity.

    Science.gov (United States)

    Bongers, Mathilda L; de Ruysscher, Dirk; Oberije, Cary; Lambin, Philippe; Uyl-de Groot, Carin A; Coupé, V M H

    2016-01-01

    With the shift toward individualized treatment, cost-effectiveness models need to incorporate patient and tumor characteristics that may be relevant to treatment planning. In this study, we used multistate statistical modeling to inform a microsimulation model for cost-effectiveness analysis of individualized radiotherapy in lung cancer. The model tracks clinical events over time and takes patient and tumor features into account. Four clinical states were included in the model: alive without progression, local recurrence, metastasis, and death. Individual patients were simulated by repeatedly sampling a patient profile, consisting of patient and tumor characteristics. The transitioning of patients between the health states is governed by personalized time-dependent hazard rates, which were obtained from multistate statistical modeling (MSSM). The model simulations for both the individualized and conventional radiotherapy strategies demonstrated internal and external validity. Therefore, MSSM is a useful technique for obtaining the correlated individualized transition rates that are required for the quantification of a microsimulation model. Moreover, we have used the hazard ratios, their 95% confidence intervals, and their covariance to quantify the parameter uncertainty of the model in a correlated way. The obtained model will be used to evaluate the cost-effectiveness of individualized radiotherapy treatment planning, including the uncertainty of input parameters. We discuss the model-building process and the strengths and weaknesses of using MSSM in a microsimulation model for individualized radiotherapy in lung cancer.

  8. The effect study of carrying out group seeing a doctor management mode on the community patients with schizophrenia%群组看病管理模式对社区精神分裂症患者的康复效果

    Institute of Scientific and Technical Information of China (English)

    吴春荣; 高彩凤; 吴英锋

    2012-01-01

    目的 探讨群组看病管理模式对社区精神分裂症患者的康复效果,为开展社区精神分裂症康复管理提供依据.方法 将临床“痊愈”出院的精神分裂症患者160例按抛硬币分组法随机分为研究组(84例)和对照组(76例),研究组建立以社区卫生服务中心为依托的精神病防治点,对社区精神分裂症患者实施群组看病管理模式,观察时间为1年;对照组实施自我护理模式,不给予任何形式的社区医疗护理干预.干预前后,采用阳性和阴性症状量表(PANSS)、服药依从性、社会功能缺陷筛查量表(SDSS)、综合生活质量评定问卷(GQOLI - 74)以及复发率进行效果评估.结果 干预前(出院时),两组PANSS、SDSS和GQOLI -74评定无明显差异(P>0.05),出院6个月、9个月及1年后,研究组PANSS,SDSS总分以及复发率明显低于对照组,而服药依从性、GQOLI - 74评分明显高于对照组,差异具有统计学意义(P<0.01).结论对社区精神分裂症患者实施群组看病管理模式能够稳定患者病情,改善社会功能,提高遵医行为和生活质量,降低复发,对促进患者良好康复具有积极的作用.%Objective To explore the rehabilitation effect of the group seeing a doctor management mode for the community patients with schizophrenia,in order to provide the basis of the rehabilitation management for community patients with schizophrenia.Methods Totaled of 160 clinical healed inpatients with schizophrenia were randomly divided into study groups ( 84 patients) and the control group (76 cases),the study group established the mental illness control point that relied on community health service center.Group seeing a doctor management mode was carried out for the community patients with schizophrenia.The observing time lasted for a year.The control group carried out the self- nursing mode without community health nursing intervention.Before and after the intervention,the effect was assessed by PANSS

  9. A polynomial model of patient-specific breathing effort during controlled mechanical ventilation.

    Science.gov (United States)

    Redmond, Daniel P; Docherty, Paul D; Yeong Shiong Chiew; Chase, J Geoffrey

    2015-08-01

    Patient breathing efforts occurring during controlled ventilation causes perturbations in pressure data, which cause erroneous parameter estimation in conventional models of respiratory mechanics. A polynomial model of patient effort can be used to capture breath-specific effort and underlying lung condition. An iterative multiple linear regression is used to identify the model in clinical volume controlled data. The polynomial model has lower fitting error and more stable estimates of respiratory elastance and resistance in the presence of patient effort than the conventional single compartment model. However, the polynomial model can converge to poor parameter estimation when patient efforts occur very early in the breath, or for long duration. The model of patient effort can provide clinical benefits by providing accurate respiratory mechanics estimation and monitoring of breath-to-breath patient effort, which can be used by clinicians to guide treatment.

  10. Predictive Models for Identification of Hospitalized Patients Harboring KPC-Producing Klebsiella pneumoniae

    Science.gov (United States)

    Trecarichi, Enrico Maria; Tumietto, Fabio; Del Bono, Valerio; De Rosa, Francesco Giuseppe; Bassetti, Matteo; Losito, Angela Raffaella; Tedeschi, Sara; Saffioti, Carolina; Corcione, Silvia; Giannella, Maddalena; Raffaelli, Francesca; Pagani, Nicole; Bartoletti, Michele; Spanu, Teresa; Marchese, Anna; Cauda, Roberto; Viscoli, Claudio; Viale, Pierluigi

    2014-01-01

    The production of Klebsiella pneumoniae carbapenemases (KPCs) by Enterobacteriaceae has become a significant problem in recent years. To identify factors that could predict isolation of KPC-producing K. pneumoniae (KPCKP) in clinical samples from hospitalized patients, we conducted a retrospective, matched (1:2) case-control study in five large Italian hospitals. The case cohort consisted of adult inpatients whose hospital stay included at least one documented isolation of a KPCKP strain from a clinical specimen. For each case enrolled, we randomly selected two matched controls with no KPCKP-positive cultures of any type during their hospitalization. Matching involved hospital, ward, and month/year of admission, as well as time at risk for KPCKP isolation. A subgroup analysis was also carried out to identify risk factors specifically associated with true KPCKP infection. During the study period, KPCKP was isolated from clinical samples of 657 patients; 426 of these cases appeared to be true infections. Independent predictors of KPCKP isolation were recent admission to an intensive care unit (ICU), indwelling urinary catheter, central venous catheter (CVC), and/or surgical drain, ≥2 recent hospitalizations, hematological cancer, and recent fluoroquinolone and/or carbapenem therapy. A Charlson index of ≥3, indwelling CVC, recent surgery, neutropenia, ≥2 recent hospitalizations, and recent fluoroquinolone and/or carbapenem therapy were independent risk factors for KPCKP infection. Models developed to predict KPCKP isolation and KPCKP infection displayed good predictive power, with the areas under the receiver-operating characteristic curves of 0.82 (95% confidence interval [CI], 0.80 to 0.84) and 0.82 (95% CI, 0.80 to 0.85), respectively. This study provides novel information which might be useful for the clinical management of patients harboring KPCKP and for controlling the spread of this organism. PMID:24733460

  11. Analysis of genetics mechanism for the phenotypic diversity in a patient carrying a rare ring chromosome 9%一例罕见r(9)患儿的临床表型异质性的遗传学机制分析

    Institute of Scientific and Technical Information of China (English)

    秦胜芳; 汪雪雁; 李运星; 魏萍; 陈春; 曾兰

    2016-01-01

    Objective To explore the genetics mechanism for the phenotypic variability in a patient carrying a rare ring chromosome 9.Methods The karyotype of the patient was analyzed with cytogenetics method.Presence of sex chromosome was confirmed with fluorescence in situ hybridization.The SRY gene was subjected to PCR amplification and direct sequencing.Potential deletion and duplication were detected with array-based comparative genomic hybridization(array-CGH).Results The karyotype of the patient has comprised 6 types of cell lines containing a ring chromosome 9.The SRY gene sequence was normal.By array-CGH,the patient has carried a hemizygous deletion at 9p24.3-p23(174 201-9 721 761) encompassing 30 genes from Online Mendelian Inheritance in Man.Conclusion The phenotypic variability of the 9p deletion syndrome in conjunct with ring chromosome 9 may be attributable to multiple factors including loss of chromosomal material,insufficient dosage of genes,instability of ring chromosome,and pattern of inheritance.%目的 探讨1例9号环状染色体患儿临床表型异质性的细胞和分子遗传机制.方法 应用细胞遗传学方法分析患儿的染色体核型,荧光原位杂交(fluorescence in situ hybridization,FISH)技术分析其性染色体,PCR扩增后进行SRY基因的测序,微阵列比较基因组杂交(array-based comparative genomic hybridization,array-CGH)基因芯片检测患儿染色体缺失的情况,并进行生物信息学分析.结果 患儿为6种细胞嵌合的9号环状染色体核型,FISH分析显示性染色体为XY,测序显示SRY基因序列正常,array-CGH基因芯片检出9p24.3-p23(174 201-9 721 761)单倍缺失,生物信息学分析提示缺失区域包含有与疾病相关的30个基因.结论 9号环状染色体部分短臂缺失的临床表现多样性与遗传物质的丢失、基因单倍剂量不足、环不稳定性以及遗传方式等多因素相关.

  12. Clinical prediction model to identify vulnerable patients in ambulatory surgery: towards optimal medical decision-making

    NARCIS (Netherlands)

    H. Mijderwijk (Herjan); R.J. Stolker (Robert); H.J. Duivenvoorden (Hugo); M. Klimek (Markus); E.W. Steyerberg (Ewout)

    2016-01-01

    markdownabstract__Background:__ Ambulatory surgery patients are at risk of adverse psychological outcomes such as anxiety, aggression, fatigue, and depression. We developed and validated a clinical prediction model to identify patients who were vulnerable to these psychological outcome parameters.

  13. [Simple locomotion and during load carrying in pregnant women].

    Science.gov (United States)

    Golomer, E; Ducher, D; Arfi, G S; Sud, R

    1991-01-01

    There have been few studies of the way women walk in pregnancy, though some of the causes of low back ache of which they complain have only been partially worked out. This is why this study has been carried out on ten women between the third and eighth month of pregnancy. The speed at which they walk and the parameters of the gait as well as the localization of the centre of gravity when keeping upright have been measured in these pregnant women as well as in twenty control women of the same age. The results show that the speed at which they walk whether with or without carrying a weight usually is identical at the beginning and the end of pregnancy. When walking normally the size of the steps taken are no larger in pregnant women than in the control patients (p less than 0.05). Though the results are not statistically significant the rhythm of the steps is faster as well as their being a reduction in the length of the steps between the third and eighth month of pregnancy. When carrying a weight the length of the steps does not change greatly with pregnancy (p less than 0.05) and it would seem therefore to be a good way of assessing the changes that locomotion undergoes in pregnancy. The fact that women do not walk faster or slower can give evidence that they adapt to the change in posture that happens in pregnancy and they make the best possible biomechanical use of the parameters of walking in order to economise total energy output of the organism.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. The Population Carrying Capacity of Water Resources in Yulin City

    Institute of Scientific and Technical Information of China (English)

    Lijuan; DANG; Yong; XU; Zhiqiang; WANG

    2014-01-01

    Assessing the water resource carrying capacity is beneficial for measuring the scale of industry and population agglomeration,and also avoiding the contradiction between increasing people and decreasing available water resource,due to the expansion of industry and city size.Based on the prediction model of optimum population development size,by using hydrological data,also with the demographic data from 1956 to 2010,this article analyzes and predicts the urban moderate scale under the limit of the water resource in the future of Yulin City by GIS. The main conclusions are as follows. There is growing tendency of water resources overloading. According to the result of model simulation,by2015,the overload rate of population size will be 1. 04. By 2020,the overload rate of population size will grow up to 1. 08. The oversized population mainly comes from cities and towns. The overload rate for cities and towns in 2015 and 2020 is 1. 89 and 1. 73,respectively. With the expansion of cities and industries,suburban areas could have a great potential for carrying population,because lots of suburban people may move to cities and towns according to prediction. In view of the above-mentioned facts,the population size should be controlled in a reasonable range.

  15. Mathematical model explaining iron change in patients with thalassemia

    Institute of Scientific and Technical Information of China (English)

    Somsri; Wiwanitkit; Viroj; Wiwanitkit

    2015-01-01

    Dear Editor,Hemoglobin is an important biochemical pigment seen within erythrocytes.The hemoglobin is the most important content within the red cell.It functions for oxygen carrying,hence,it is very important for human beings.The abnormality of hemoglobin is common in medical practice.The low hemoglobin level from complete blood count is common problem in

  16. Minimal model quantification of pulmonary gas exchange in intensive care patients

    DEFF Research Database (Denmark)

    Karbing, Dan Stieper; Kjærgaard, Søren; Andreassen, Steen

    2011-01-01

    of both oxygen and carbon dioxide. Three models of varying complexity were compared for their ability to fit measured data from intensive care patients and to provide adequate description of patients' gas exchange abnormalities. Pairwise F-tests showed that a two parameter model provided superior fit......Mathematical models are required to describe pulmonary gas exchange. The challenge remains to find models which are complex enough to describe physiology and simple enough for clinical practice. This study aimed at finding the necessary 'minimal' modeling complexity to represent the gas exchange...... to patient data compared to a shunt only model (p...

  17. Fault tolerant reversible logic synthesis: Carry look-ahead and carry-skip adders

    CERN Document Server

    Islam, Md Saiful; Begum, Zerina; Hafiz, Mohd Zulfiquar; 10.1109/ACTEA.2009.5227871

    2010-01-01

    Irreversible logic circuits dissipate heat for every bit of information that is lost. Information is lost when the input vector cannot be recovered from its corresponding output vector. Reversible logic circuit naturally takes care of heating because it implements only the functions that have one-to-one mapping between its input and output vectors. Therefore reversible logic design becomes one of the promising research directions in low power dissipating circuit design in the past few years and has found its application in low power CMOS design, digital signal processing and nanotechnology. This paper presents the efficient approaches for designing reversible fast adders that implement carry look-ahead and carry-skip logic. The proposed 16-bit high speed reversible adder will include IG gates for the realization of its basic building block. The IG gate is universal in the sense that it can be used to synthesize any arbitrary Boolean-functions. The IG gate is parity preserving, that is, the parity of the input...

  18. Cognitive Load in Voice Therapy Carry-Over Exercises

    DEFF Research Database (Denmark)

    Iwarsson, Jenny; Morris, David Jackson; Balling, Laura Winther

    2017-01-01

    Purpose The cognitive load generated by online speech production may vary with the nature of the speech task. This article examines 3 speech tasks used in voice therapy carry-over exercises, in which a patient is required to adopt and automatize new voice behaviors, ultimately in daily spontaneous...... communication. Method Twelve subjects produced speech in 3 conditions: rote speech (weekdays), sentences in a set form, and semispontaneous speech. Subjects simultaneously performed a secondary visual discrimination task for which response times were measured. On completion of each speech task, subjects rated...... their experience on a questionnaire. Results Response times from the secondary, visual task were found to be shortest for the rote speech, longer for the semispontaneous speech, and longest for the sentences within the set framework. Principal components derived from the subjective ratings were found to be linked...

  19. Integrative Health Coach Training: A Model for Shifting the Paradigm Toward Patient-centricity and Meeting New National Prevention Goals

    Science.gov (United States)

    Smith, Linda L.; Lake, Noelle H.; Simmons, Leigh Ann; Perlman, Adam; Wroth, Shelley

    2013-01-01

    Objective: To describe the evolution, training, and results of an emerging allied health profession skilled in eliciting sustainable health-related behavior change and charged with improving patient engagement. Methods: Through techniques sourced from humanistic and positive psychology, solution-focused and mindfulness-based therapies, and leadership coaching, Integrative Health Coaching (IHC) provides a mechanism to empower patients through various stages of learning and change. IHC also provides a method for the creation and implementation of forward-focused personalized health plans. Results: Clinical studies employing Duke University Integrative Medicine's model of IHC have demonstrated improvements in measures of diabetes and diabetes risk, weight management, and risk for cardiovascular disease and stroke. By supporting and enabling individuals in making major lifestyle changes for the improvement of their health, IHC carries the potential to reduce rates and morbidity of chronic disease and impact myriad aspects of healthcare. Conclusion: As a model of educational and clinical innovation aimed at patient empowerment and lifestyle modification, IHC is aligned well with the tenets and goals of recently sanctioned federal healthcare reform, specifically the creation of the first National Prevention and Health Promotion Strategy. Practice Implications: IHC may allow greater patient-centricity while targeting the lifestyle-related chronic disease that lies at the heart of the current healthcare crisis. PMID:24416674

  20. Comparison of Oxygen Carrying Capacity of Red Blood Cell in Salvaged Blood of Patients Undergoing Orthopedic Surgery vs Peripheral Blood Before Anesthesia%骨科手术中回收血红细胞与患者麻醉前红细胞携氧能力的比较

    Institute of Scientific and Technical Information of China (English)

    邱颐; 丁玉美; 崔永武; 安敏

    2011-01-01

    [Objective]To compare the difference of oxygen carrying capacity of red blood cell between salvaged blood of patients undergoing orthopedic surgery and peripheral blood before anesthesia. [Methods] Thirty patients undergoing orthopedic surgery received autologous blood transfusion by using blood salvage machine during operation. Thirty blood samples in each of salvaged blood processed by blood salvage machine and peripheral blood before anesthesia were drawn.The pH of blood samples in two groups was measured. The formula was used to calculate 50 % partial pressure of oxygen (P50) in blood samples. The level of 2,3-diphosphoglycerate(2,3- DPG) in erythrocytes was measured by radioimmunoas say and red cell deformability index(RCD) was determined on blood rheology instrument. [Results] The pH and P50 in salvaged blood were higher than those in peripheral blood before anesthesia, but there was no significant difference( P > 0.05). There was also no significant difference in 2,3 DPG level and RCD between salvaged blood and peripheral blood before anesthesia( P >0.05). [Conclusion] The oxygen carrying capacity of red blood cell in salvaged blood of patients undergoing orthopedic surgery is the same as that in peripheral blood before anesthesia.%[目的]比较骨科患者术中回收血红细胞与麻醉前红细胞携氧能力的差异.[方法]使用血液回收机对30例骨科手术患者行术中自体血液回收.取血液回收机处理后的回收血和麻醉前患者外周血各30份,检测两组血样的pH、根据公式计算血样的50%氧分压(P50),采用放射免疫法测定红细胞内2,3-二磷酸甘油酸浓度(2,3-DPG)、在血液流变仪上测定红细胞变形指数(RCD).[结果]回收血样pH值、P50高于麻醉前血样,但无显著性差异(P>0.05);2,3-DPG 浓度、RCD与麻醉前血样比较差异亦无显著性(P>0.05).[结论]骨科患者术中回收血红细胞与麻醉前外周血红细胞具有相同的携氧能力.

  1. An integrative model of patient-centeredness - a systematic review and concept analysis.

    Directory of Open Access Journals (Sweden)

    Isabelle Scholl

    Full Text Available Existing models of patient-centeredness reveal a lack of conceptual clarity. This results in a heterogeneous use of the term, unclear measurement dimensions, inconsistent results regarding the effectiveness of patient-centered interventions, and finally in difficulties in implementing patient-centered care. The aim of this systematic review was to identify the different dimensions of patient-centeredness described in the literature and to propose an integrative model of patient-centeredness based on these results.Protocol driven search in five databases, combined with a comprehensive secondary search strategy. All articles that include a definition of patient-centeredness were eligible for inclusion in the review and subject to subsequent content analysis. Two researchers independently first screened titles and abstracts, then assessed full texts for eligibility. In each article the given definition of patient-centeredness was coded independently by two researchers. We discussed codes within the research team and condensed them into an integrative model of patient-centeredness.4707 records were identified through primary and secondary search, of which 706 were retained after screening of titles and abstracts. 417 articles (59% contained a definition of patient-centeredness and were coded. 15 dimensions of patient-centeredness were identified: essential characteristics of clinician, clinician-patient relationship, clinician-patient communication, patient as unique person, biopsychosocial perspective, patient information, patient involvement in care, involvement of family and friends, patient empowerment, physical support, emotional support, integration of medical and non-medical care, teamwork and teambuilding, access to care, coordination and continuity of care. In the resulting integrative model the dimensions were mapped onto different levels of care.The proposed integrative model of patient-centeredness allows different stakeholders to speak

  2. An Integrative Model of Patient-Centeredness – A Systematic Review and Concept Analysis

    Science.gov (United States)

    Scholl, Isabelle; Zill, Jördis M.; Härter, Martin; Dirmaier, Jörg

    2014-01-01

    Background Existing models of patient-centeredness reveal a lack of conceptual clarity. This results in a heterogeneous use of the term, unclear measurement dimensions, inconsistent results regarding the effectiveness of patient-centered interventions, and finally in difficulties in implementing patient-centered care. The aim of this systematic review was to identify the different dimensions of patient-centeredness described in the literature and to propose an integrative model of patient-centeredness based on these results. Methods Protocol driven search in five databases, combined with a comprehensive secondary search strategy. All articles that include a definition of patient-centeredness were eligible for inclusion in the review and subject to subsequent content analysis. Two researchers independently first screened titles and abstracts, then assessed full texts for eligibility. In each article the given definition of patient-centeredness was coded independently by two researchers. We discussed codes within the research team and condensed them into an integrative model of patient-centeredness. Results 4707 records were identified through primary and secondary search, of which 706 were retained after screening of titles and abstracts. 417 articles (59%) contained a definition of patient-centeredness and were coded. 15 dimensions of patient-centeredness were identified: essential characteristics of clinician, clinician-patient relationship, clinician-patient communication, patient as unique person, biopsychosocial perspective, patient information, patient involvement in care, involvement of family and friends, patient empowerment, physical support, emotional support, integration of medical and non-medical care, teamwork and teambuilding, access to care, coordination and continuity of care. In the resulting integrative model the dimensions were mapped onto different levels of care. Conclusions The proposed integrative model of patient-centeredness allows different

  3. Effect of Da-Cheng-Qi Decoction on Pancreatitis-Associated Intestinal Dysmotility in Patients and in Rat Models

    Directory of Open Access Journals (Sweden)

    Jianlei Zhao

    2015-01-01

    Full Text Available The impairment of intestinal motility and related infectious complications are the predominant clinical phenomenon in patients with severe acute pancreatitis (SAP. We aimed to investigate the effects of Da-Cheng-Qi decoction (DCQD on the gastrointestinal injury in SAP patients and the potential mechanism involved in rats. DCQD was enema administered to 70 patients for 7 days in West China Hospital. Mortality and organ failure during admission were observed and blood samples for laboratory analysis were collected. We also experimentally examined plasma inflammatory cytokines in rat serum and carried the morphometric studies of the gut. Intestinal propulsion index and serum and tissue vasoactive intestinal peptide (VIP were also detected. Though DCQD did not affect the overall incidence of organ failure, it shortened the average time of paralytic intestinal obstruction and decreased the morbidity of infectious complications in patients with SAP. Compared with untreated rats, the DCQD lowered the levels of proinflammatory cytokine and decreased the mean pathological intestinal lesion scores. The VIP level in intestinal tissue or serum in DCQD group was obviously lowered and intestinal propulsion index was significantly improved. In conclusion, DCQD has good effect on pancreatitis-associated intestinal dysmotility in patients and in rat models.

  4. Physiologically Based Pharmacokinetic (PBPK model for biodistribution of radiolabeled peptides in patients with neuroendocrine tumours

    Directory of Open Access Journals (Sweden)

    Viktor Popov

    2016-07-01

    Full Text Available Objective(s: The objectives of this work was to assess the benefits of the application of Physiologically Based Pharmacokinetic (PBPK models in patients with different neuroendocrine tumours (NET who were treatedwith Lu-177 DOTATATE. The model utilises clinical data on biodistribution of radiolabeled peptides (RLPs obtained by whole body scintigraphy (WBS of the patients.Methods: The blood flow restricted (perfusion rate limited type of the PBPK model for biodistribution of radiolabeled peptides (RLPs in individual human organs is based on the multi-compartment approach, which takes into account the main physiological processes in the organism: absorption, distribution, metabolism and excretion (ADME. The approachcalibrates the PBPK model for each patient in order to increase the accuracy of the dose estimation. Datasets obtained using WBS in four patients have been used to obtain the unknown model parameters. The scintigraphic data were acquired using a double head gamma camera in patients with different neuroendocrine tumours who were treated with Lu-177 DOTATATE. The activity administered to each patient was 7400MBq.Results: Satisfactory agreement of the model predictions with the data obtained from the WBS for each patient has been achieved. Conclusion: The study indicates that the PBPK model can be used for more accurate calculation of biodistribution and absorbed doses in patients. This approach is the first attempt of utilizing scintigraphic data in PBPK models, which was obtained during Lu-177 peptide therapy of patients with NET.

  5. A Group of Asthma Patients\\\\\\' Treatment Related Thoughts Based on Health Belief Model and Perception of Medication Success

    Directory of Open Access Journals (Sweden)

    Mesut Cimen

    2012-02-01

    Full Text Available Purpose: This study is a descriptive study which aims to determine the attitude and perceptions of asthma patients about their health and their opinion regarding the success of treatment. Method: The study is carried out without any sampling. The participants are 74 patients who were admitted in a public pulmonary disease clinic between April and June 2010. A revised version of Health Belief Model scale for asthma treatment and another scale, which was developed to determine the opinion and observations of patients regarding the success of treatment, are used for data collection. In addition to descriptive statistics, regression analysis, Mann-Whitney U and Kruskal Wallis tests are used in the data analysis. Findings: The mean score of attitudes and perceptions of asthma patients, which is defined with the Health Belief Model and which can affect their responsiveness to treatment, is found out 3,37(±0,38 and the attitude and perceptions of patients are positive. The mean value for success treatment is 2,35(±0,49. Since the treatment is deemed to be more successful as it gets closer to 1 hence it can be said that the opinion of asthma patients regarding the success of treatment is positive. In the study, it is found out that the participants have a high admission rate to hospitals and that there is no significant difference for socio-demographic characteristics in the positive attitude development and in their belief in the efficiency of the treatment that they are receiving, of which both are components of health belief model concept. The findings from regression analysis indicate that the duration of the asthma sickness and the number of people living in the household not only affect the perceptions and attitudes of patients that are investigated by health belief model, but also the effectiveness of the treatment and the number of admissions to the Emergency Room in the last 6 months. Conclusion: In order to prevent long-term complications

  6. Complicações dos estomas em câncer colorretal: revisão de 21 complicações em 276 estomas realizados em 870 pacientes portadores de câncer colorretal Complications of stomas in colorectal cancer: review of 21 complications in 276 stomas carried out in 870 patients with colorectal cancer

    Directory of Open Access Journals (Sweden)

    Geraldo Magela Gomes da Cruz

    2008-03-01

    of the anus. In 490 cases (53.1% cancer were localized in the colon and in 380 (41.2% in the rectum. The aim of this report is to study these 870 patients bearing colorectal cancer analyzing, specially, the 276 stomas carried out (31.7%, classifying them in temporary and definitive, describing their modalities and indications as well as their complications and surgical techniques used to approach them. Operability rate was 98.1% (853 patients, being 90.6% (778 patients the incidence of resected tumors. The most used surgical techniques to approach the disease were abdominal colon resection with anastomoses (617 cases, 70.9% and abdominoperineal resection (15.5%. Stomas were made in 276 patients (31.7%, being 73 temporary (8.4% and 203 definitive (23.3%. End colostomy was the most common type of stoma carried out (181 cases, 21.2%. Loop ileostomy was the most common temporary stoma (33 cases, 3.9% and end colostomy the most common definitive stoma (156 cases, 18.3%. Incidence of complications was 7.6% (21 cases, and loop colostomy and loop ileostomy the stomas with the highest incidence of complications: 9.1% each. End ileostomy did not show any complication. The most frequent complication was stoma prolapse (six cases, necrosis (five cases and stenosis (five cases. The main procedures for surgical approach were pericolostomy incision with correction of the stoma (12 cases and laparotomy and colectomy making a new stoma (five cases.

  7. Patient Modeling for Simulation Guided Head and Neck Hyperthermia

    NARCIS (Netherlands)

    R.F. Verhaart (René)

    2016-01-01

    markdownabstractThe prognosis for patients with advanced head and neck (H&N) cancer is very poor and treatment is challenging. These patients are standardly treated with radiotherapy with or without chemotherapy. These treatments are associated with a high treatment related late toxicity that affect

  8. Patient Modeling for Simulation Guided Head and Neck Hyperthermia

    NARCIS (Netherlands)

    R.F. Verhaart (René)

    2016-01-01

    markdownabstractThe prognosis for patients with advanced head and neck (H&N) cancer is very poor and treatment is challenging. These patients are standardly treated with radiotherapy with or without chemotherapy. These treatments are associated with a high treatment related late toxicity that affect

  9. An Integrated Model of Patient and Staff Satisfaction Using Queuing Theory.

    Science.gov (United States)

    Komashie, Alexander; Mousavi, Ali; Clarkson, P John; Young, Terry

    2015-01-01

    This paper investigates the connection between patient satisfaction, waiting time, staff satisfaction, and service time. It uses a variety of models to enable improvement against experiential and operational health service goals. Patient satisfaction levels are estimated using a model based on waiting (waiting times). Staff satisfaction levels are estimated using a model based on the time spent with patients (service time). An integrated model of patient and staff satisfaction, the effective satisfaction level model, is then proposed (using queuing theory). This links patient satisfaction, waiting time, staff satisfaction, and service time, connecting two important concepts, namely, experience and efficiency in care delivery and leading to a more holistic approach in designing and managing health services. The proposed model will enable healthcare systems analysts to objectively and directly relate elements of service quality to capacity planning. Moreover, as an instrument used jointly by healthcare commissioners and providers, it affords the prospect of better resource allocation.

  10. Applying an artificial neural network model for developing a severity score for patients with hereditary amyloid polyneuropathy.

    Science.gov (United States)

    Novis, Shenia; Machado, Felipe; Costa, Victor B; Foguel, Debora; Cruz, Marcia W; de Seixas, José Manoel

    2017-09-01

    Hereditary (familial) amyloid polyneuropathy (FAP) is a systemic disease that includes a sensorimotor polyneuropathy related to transthyretin (TTR) mutations. So far, a scale designed to classify the severity of this disease has not yet been validated. This work proposes the implementation of an artificial neural network (ANN) in order to develop a severity scale for monitoring the disease progression in FAP patients. In order to achieve this goal, relevant symptoms and laboratory findings were collected from 98 Brazilian patients included in THAOS - the Transthyretin Amyloidosis Outcomes Survey. Ninety-three percent of them bore Val30Met, the most prevalent variant of TTR worldwide; 63 were symptomatic and 35 were asymptomatic. These data were numerically codified for the purpose of constructing a Self-Organizing Map (SOM), which maps data onto a grid of artificial neurons. Mapped data could be clustered by similarity into five groups, based on increasing FAP severity (from Groups 1 to 5). Most symptoms were virtually absent from patients who mapped to Group 1, which also includes the asymptomatic patients. Group 2 encompasses the patients bearing symptoms considered to be initial markers of FAP, such as first signs of walking disabilities and lack of sensitivity to temperature and pain. Interestingly, the patients with cardiac symptoms, which also carry cardiac-associated mutations of the TTR gene (such as Val112Ile and Ala19Asp), were concentrated in Group 3. Symptoms such as urinary and fecal incontinence and diarrhea characterized particularly Groups 4 and 5. Renal impairment was found almost exclusively in Group 5. Model validation was accomplished by considering the symptoms from a sample with 48 additional Brazilian patients. The severity scores proposed here not only identify the current stage of a patient's disease but also offer to the physician an easy-to-read, 2D map that makes it possible to track disease progression.

  11. Effect of Abnormal Savda Munziq on urine metabolites from Abnormal Savda Syndrome carrying asthma rat model%维药异常黑胆质成熟剂对异常黑胆质型支气管哮喘模型大鼠尿液代谢物的影响

    Institute of Scientific and Technical Information of China (English)

    娜祖科·库尔班塔依; 巴吐尔·买买提明; 买吾拉尼江·依孜布拉; Denise Dubrovin; 哈木拉提·吾甫尔

    2014-01-01

    目的:探讨维药异常黑胆质成熟剂对异常黑胆质型支气管哮喘大鼠尿液代谢物变化的影响。方法应用多因素复合作用建立异常黑胆质证载体动物模型,采用卵清蛋白(OVA)致敏和雾化激发方法建立异常黑胆质型支气管哮喘病证模型,将SD大鼠(84只)随机分为空白对照组、异常黑胆质证载体模型组、异常黑胆质证型支气管哮喘模型组、异常黑胆质成熟剂给药组(分为大、中、小剂量组)、地塞米松给药阳性对照组。收集各组大鼠尿液,利用核磁共振波谱(1 H -NMR)技术测定核磁共振氢谱,建立大鼠尿液的代谢指纹谱,运用正交偏最小二乘判别分析(OPLS -DA)法分析各组大鼠尿液中代谢产物差异。结果与空白对照组相比,异常黑胆质型哮喘模型组柠檬酸、肌酸酐、甘氨酸等重要氨基酸含量降低,差异有统计学意义(P <0.05);灌胃异常黑胆质成熟剂之后,异常黑胆质型哮喘模型组降低的肌酸酐及乙酸等含量明显增高,牛磺酸、甜菜碱等含量降低,与异常黑胆质型哮喘模型组比较差异有统计学意义(P <0.05);与异常黑胆质型哮喘模型组相比,地塞米松给药阳性对照组马尿酸、乳酸、丙氨酸等含量升高(P <0.05)。结论异常黑胆质成熟剂对异常黑胆质型哮喘大鼠代谢具有显著影响,其作用机制可能是通过作用于异常黑胆质型支气管哮喘大鼠体内氨基酸代谢与能量代谢途径而发挥预防及治疗异常黑胆质型支气管哮喘的作用。%Objective To study the effect of Abnormal Savda Munziq on urine metabolic changes of Abnor‐mal Savda Syndrome carrying asthma rat model .Methods Multiple factors was used to establish Abnor‐mal Savda rat model ,according to the Traditional Uyghur Medicine .By sensitization and challenge with ovalbumin (OVA) Abnormal Savda Syndrome carrying rat model

  12. 艾司洛尔与急性心肌梗死患者红细胞携氧能力的关系研究%Study on the Relationship Between Esmolol and Erythrocyte Oxygen Carrying Capacity in Pa-tients with Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    孙向华; 韩莲花; 李红霞; 惠杰

    2014-01-01

    【目的】探讨艾司洛尔是否影响急性心肌梗死患者红细胞血红蛋白的携氧能力。【方法】采集急性心肌梗死患者红细胞,悬浮于不同pH值(pH7.4、pH5.0)等渗PBS缓冲液,分别用肾上腺素、艾司洛尔、艾司洛尔+肾上腺素预处理红细胞,在拉曼光谱点扫描检测单个活态红细胞内血红蛋白特征光谱变化。【结果】在pH5.0时,氧化血红蛋白特征峰峰强在PBS、艾司洛尔的作用下明显降低;在肾上腺素的作用下显著升高(P<0.05);而经艾司洛尔+肾上腺索预处理后,肾上腺素的这一作用不明显。【结论】艾司洛尔能减轻肾上腺素在酸性环境中增加红细胞血红蛋白的氧合力的作用,增加氧从血红蛋白的解离,有利于缺氧组织的供氧。%[Obj ective]To explore whether esmolol affects erythrocyte oxygen carrying capacity in patients with acute myocardial infarction.[Methods]Erythrocytes from patients with acute myocardial infarction were collected and suspended in isotonic PBS buffer solution with different pH value(pH7.4 and pH5.0).Erythro-cytes were pretreated with adrenaline,esmolol and adrenaline plus esmolol,respectively.The characteristic spectral changes of hemoglobin in single living erythrocytes were detected by using Raman spectroscopy analy-sis.[Results]Characteristic peak of oxyhemoglobin treated with PBS and esmolol at pH5.0 was decreased obvi-ously,but that treated with adrenaline was increased significantly. After pretreatment with esmolol plus adrenaline,the effect of adrenaline was not obvious.[Conclusion]Esmolol can reduce the effect of adrenaline for enhancing erythrocyte oxygen carrying capacity of hemoglobin in acid environment,and increase the disso-ciation of oxygen from hemoglobin,and is helpful for oxygen supply of anoxia tissue.

  13. Generating unique IDs from patient identification data using security models

    Directory of Open Access Journals (Sweden)

    Emad A Mohammed

    2016-01-01

    Full Text Available Background: The use of electronic health records (EHRs has continued to increase within healthcare systems in the developed and developing nations. EHRs allow for increased patient safety, grant patients easier access to their medical records, and offer a wealth of data to researchers. However, various bioethical, financial, logistical, and information security considerations must be addressed while transitioning to an EHR system. The need to encrypt private patient information for data sharing is one of the foremost challenges faced by health information technology. Method: We describe the usage of the message digest-5 (MD5 and secure hashing algorithm (SHA as methods for encrypting electronic medical data. In particular, we present an application of the MD5 and SHA-1 algorithms in encrypting a composite message from private patient information. Results: The results show that the composite message can be used to create a unique one-way encrypted ID per patient record that can be used for data sharing. Conclusion: The described software tool can be used to share patient EMRs between practitioners without revealing patients identifiable data.

  14. Patient Decisions to Receive Secondary Pharmacogenomic Findings and Development of a Multidisciplinary Practice Model to Integrate Results Into Patient Care.

    Science.gov (United States)

    Hicks, J Kevin; Shealy, Amy; Schreiber, Allison; Coleridge, Marissa; Noss, Ryan; Natowicz, Marvin; Moran, Rocio; Moss, Timothy; Erwin, Angelika; Eng, Charis

    2017-07-27

    Whole exome sequencing (WES) has the potential of identifying secondary findings that are predictive of poor pharmacotherapy outcomes. The purpose of this study was to investigate patients' wishes regarding the reporting of secondary pharmacogenomic findings. WES results (n = 106 patients) were retrospectively reviewed to determine the number of patients electing to receive secondary pharmacogenomic results. Phenotypes were assigned based on Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. The percent of patients with a predicted phenotype associated with a gene-based CPIC dosing recommendation was determined. Ninety-nine patients (93.4%) elected to receive secondary pharmacogenomic findings. For each gene-drug pair analyzed, the number of patients with an actionable phenotype ranged from two (2%) to 43 patients (43.4%). Combining all gene-drug pairs, 84 unique patients (84.8%) had an actionable phenotype. A prospective multidisciplinary practice model was developed for integrating secondary pharmacogenomic findings into clinical practice. Our model highlights a unique collaboration between physician-geneticists, pharmacists, and genetic counselors. © 2017 The Authors. Clinical and Translational Science published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

  15. Research on Carrying Capacity of Water Resource Based on Multi-reservoir Regulation

    OpenAIRE

    Liu Renyuan; Li Lei; Li Hua; Huang Qiang

    2013-01-01

    Analyze the level of Carrying Capacity of Water Resources; evaluate the condition of e region social, economic and ecological environment comprehensive and sustainable development. This study is based on analyzing the meaning of water resources carrying capacity, take water resources of the Midwest of Shenzhen City an example., by the way of the “Coordinated and sustainable development” theory, found the model of the Carrying Capacity of Water Resources, Calculated and analyzed. Water efficie...

  16. Determining the appropriate model complexity for patient-specific advice on mechanical ventilation

    DEFF Research Database (Denmark)

    Rees, Stephen E.; Karbing, Dan S.

    2017-01-01

    Mathematical physiological models can be applied in medical decision support systems. To do so requires consideration of the necessary model complexity. Models that simulate changes in the individual patient are required, meaning that models should have a complexity where parameters can be unique...

  17. An Actor-Partner Interdependence Model of Acquired Brain Injury Patient Impairments and Caregiver Psychosocial Functioning

    DEFF Research Database (Denmark)

    Perrin, Paul B; Norup, Anne; Caracuel, Alfonso

    2017-01-01

    OBJECTIVE: The purpose of this study was to use actor-partner interdependence modeling (APIM) to examine the simultaneous effects of both acquired brain injury (ABI) patient and caregiver ratings of patient impairments on both patient and caregiver ratings of caregiver psychosocial dysfunction. M...

  18. Partnership and empowerment program: a model for patient-centered, comprehensive, and cost-effective care.

    Science.gov (United States)

    Brown, Corinne; Bornstein, Elizabeth; Wilcox, Catina

    2012-02-01

    The Partnership and Empowerment Program model offers a comprehensive, patient-centered, and cost-effective template for coordinating care for underinsured and uninsured patients with cancer. Attention to effective coordination, including use of internal and external resources, may result in decreased costs of care and improved patient compliance and health outcomes.

  19. Using simulation modeling to improve patient flow at an outpatient orthopedic clinic.

    Science.gov (United States)

    Rohleder, Thomas R; Lewkonia, Peter; Bischak, Diane P; Duffy, Paul; Hendijani, Rosa

    2011-06-01

    We report on the use of discrete event simulation modeling to support process improvements at an orthopedic outpatient clinic. The clinic was effective in treating patients, but waiting time and congestion in the clinic created patient dissatisfaction and staff morale issues. The modeling helped to identify improvement alternatives including optimized staffing levels, better patient scheduling, and an emphasis on staff arriving promptly. Quantitative results from the modeling provided motivation to implement the improvements. Statistical analysis of data taken before and after the implementation indicate that waiting time measures were significantly improved and overall patient time in the clinic was reduced.

  20. A Clinical model to identify patients with high-risk coronary artery disease

    NARCIS (Netherlands)

    Y. Yang (Yelin); L. Chen (Li); Y. Yam (Yeung); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D.S. Berman (Daniel); M.J. Budoff (Matthew); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor); K. Chinnaiyan (Kavitha); R.C. Cury (Ricardo); A. Delago (Augustin); A. Dunning (Allison); G.M. Feuchtner (Gudrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); R.P. Karlsberg (Ronald); P.A. Kaufmann (Philipp); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); T.M. LaBounty (Troy); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); J.K. Min (James K.); B.J.W. Chow (Benjamin)

    2015-01-01

    textabstractObjectives This study sought to develop a clinical model that identifies patients with and without high-risk coronary artery disease (CAD). Background Although current clinical models help to estimate a patient's pre-test probability of obstructive CAD, they do not accurately identify th

  1. Optimization of hospital ward resources with patient relocation using Markov chain modeling

    DEFF Research Database (Denmark)

    Andersen, Anders Reenberg; Nielsen, Bo Friis; Reinhardt, Line Blander

    2017-01-01

    that patient occupancy is reflected by our Markov chain model, and that a local optimum can be derived within a reasonable runtime.Using a Danish hospital as our case study, the Markov chain model is statistically found to reflect occupancy of hospital beds by patients as a function of how hospital beds...

  2. A Clinical model to identify patients with high-risk coronary artery disease

    NARCIS (Netherlands)

    Y. Yang (Yelin); L. Chen (Li); Y. Yam (Yeung); S. Achenbach (Stephan); M. Al-Mallah (Mouaz); D.S. Berman (Daniel); M.J. Budoff (Matthew); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); V.Y. Cheng (Victor); K. Chinnaiyan (Kavitha); R.C. Cury (Ricardo); A. Delago (Augustin); A. Dunning (Allison); G.M. Feuchtner (Gudrun); M. Hadamitzky (Martin); J. Hausleiter (Jörg); R.P. Karlsberg (Ronald); P.A. Kaufmann (Philipp); Y.-J. Kim (Yong-Jin); J. Leipsic (Jonathon); T.M. LaBounty (Troy); F.Y. Lin (Fay); E. Maffei (Erica); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); J.K. Min (James K.); B.J.W. Chow (Benjamin)

    2015-01-01

    textabstractObjectives This study sought to develop a clinical model that identifies patients with and without high-risk coronary artery disease (CAD). Background Although current clinical models help to estimate a patient's pre-test probability of obstructive CAD, they do not accurately identify th

  3. A Baseline Patient Model to Support Testing of Medical Cyber-Physical Systems.

    Science.gov (United States)

    Silva, Lenardo C; Perkusich, Mirko; Almeida, Hyggo O; Perkusich, Angelo; Lima, Mateus A M; Gorgônio, Kyller C

    2015-01-01

    Medical Cyber-Physical Systems (MCPS) are currently a trending topic of research. The main challenges are related to the integration and interoperability of connected medical devices, patient safety, physiologic closed-loop control, and the verification and validation of these systems. In this paper, we focus on patient safety and MCPS validation. We present a formal patient model to be used in health care systems validation without jeopardizing the patient's health. To determine the basic patient conditions, our model considers the four main vital signs: heart rate, respiratory rate, blood pressure and body temperature. To generate the vital signs we used regression models based on statistical analysis of a clinical database. Our solution should be used as a starting point for a behavioral patient model and adapted to specific clinical scenarios. We present the modeling process of the baseline patient model and show its evaluation. The conception process may be used to build different patient models. The results show the feasibility of the proposed model as an alternative to the immediate need for clinical trials to test these medical systems.

  4. Hospital- and patient-related characteristics determining maternity length of stay: a hierarchical linear model approach.

    Science.gov (United States)

    Leung, K M; Elashoff, R M; Rees, K S; Hasan, M M; Legorreta, A P

    1998-03-01

    The purpose of this study was to identify factors related to pregnancy and childbirth that might be predictive of a patient's length of stay after delivery and to model variations in length of stay. California hospital discharge data on maternity patients (n = 499,912) were analyzed. Hierarchical linear modeling was used to adjust for patient case mix and hospital characteristics and to account for the dependence of outcome variables within hospitals. Substantial variation in length of stay among patients was observed. The variation was mainly attributed to delivery type (vaginal or cesarean section), the patient's clinical risk factors, and severity of complications (if any). Furthermore, hospitals differed significantly in maternity lengths of stay even after adjustment for patient case mix. Developing risk-adjusted models for length of stay is a complex process but is essential for understanding variation. The hierarchical linear model approach described here represents a more efficient and appropriate way of studying interhospital variations than the traditional regression approach.

  5. Original article Rehabilitation model program for seriously ill patients

    OpenAIRE

    Adrienne Kegye; Éva Pádi; Katalin Hegedűs

    2014-01-01

    Background Patients receiving cancer treatment start lifestyle changes mostly at the end of the treatment during the rehabilitation period. Most often, the first step is a dietary change and physical exercises built into the daily routine. Patients who do this in groups led by qualified therapists and based on professional counseling can build more effective and more permanent changes into their life. To develop a complex rehabilitation program which, in the short term, aims to famil...

  6. What is Patient-Centered Care? A Typology of Models and Missions.

    Science.gov (United States)

    Tanenbaum, Sandra J

    2015-09-01

    Recently adopted health care practices and policies describe themselves as "patient-centered care." The meaning of the term, however, remains contested and obscure. This paper offers a typology of "patient-centered care" models that aims to contribute to greater clarity about, continuing discussion of, and further advances in patient-centered care. The paper imposes an original analytic framework on extensive material covering mostly US health care and health policy topics over several decades. It finds that four models of patient-centered care emphasize: patients versus their parts; patients versus providers; patients/providers/states versus "the system"; and patients and providers as persons. Each type is distinguishable along three dimensions: epistemological orientations, practical accommodations, and policy tools. Based on this analysis, the paper recommends that four questions be asked of any proposal that claims to provide patient-centered care: Is this care a means to an end or an end in itself? Are patients here subjects or objects? Are patients here individuals or aggregates? How do we know what patients want and need? The typology reveals that models are neither entirely compatible nor entirely incompatible and may be usefully combined in certain practices and policies. In other instances, internal contradictions may jeopardize the realization of coherent patient-centered care.

  7. Carrying Capacity of Marine Region in Liaoning Province

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Carrying capacity is one of important studies on coordinating development of population, resources, and environment. At present, the researches on it mainly concentrate on the carrying capacity for population and economy,such as the water resources carrying capacity, the land resources carrying capacity, the environment carrying capacity,etc. Based on the related theories and methods, this paper creatively proposed the concept and meaning of carrying capacity of marine region, and formed the appraisal system. According to the developing situation of marine economy of Liaoning Province in recent years, and by employing the method of the state space, this paper also measured the cartying capacity and carrying state of marine region and discussed the sustainable problems of marine economy of Liaoning. The research results show that the carrying state of marine region of Liaoning is in the state of overloading at present, but taking a favorable turn.

  8. Healthcare model with use of information and communication technology for patients with chronic disease.

    Science.gov (United States)

    Lisiecka-Biełanowicz, Mira; Wawrzyniak, Zbigniew

    2016-07-15

    The healthcare system is positioned in the patient's environment and works with other determinants of the treatment. Patient care requires a whole system compatible to the needs of organizational and technical solutions. The purpose of this study is to present a new model of patient-oriented care, in which the use of information and communication technology (ICT) can improve the effectiveness of healthcare for patients with chronic diseases. The study material is the process of healthcare for chronically ill patients. Knowledge of the circumstances surrounding ecosystem and of the patients' needs, taking into account the fundamental healthcare goals allows us to build a new models of care, starting with the economic assumptions. The method used is modeling the construction of efficient healthcare system with the patient-centered model using ICT tools. We present a new systemic concept of building patient's environment in which he is the central figure of the healthcare organization - so called patient centered system. The use of ICT in the model of chronic patient's healthcare can improve the effectiveness of this kind of care. The concept is a vision to making wide platform of information management in chronic disease in a real environment ecosystem of patient using ICT tools. On the basis of a systematic approach to the model of chronic disease, and the knowledge of the patient itself, a model of the ecosystem impacts and interactions through information feedback and the provision of services can be constructed. ICT assisted techniques will increase the effectiveness of patient care, in which nowadays information exchange plays a key role.

  9. [Difficult patient in dentistry. Construction of a model of personal attributes for identification].

    Science.gov (United States)

    Peñaranda Hernández, P M

    1989-01-01

    The communication between the dentist and the patient, or what we have called dentist-patient relationship constitute itself a clue to solve primary problems derived of the professional practice. In this relationship with patients, the dentist may face what we have called difficult patient. This difficult patient have several behavioral characteristics which can alter the dentist emotional equilibrium, the capacity of making proper diagnosis and finally a successful treatment may not be obtain as an end result. The difficult patient behavior may be explained by a variety of factors such as: the type of pathology, the office environment, the community and/or institution to which the patient belongs, the dentist emotional circumstance and at last the patient life style. In this research work, we interview 50 professionals from the metropolitan area with an average of 18 years in practiCe, each dentist explained situations in which the patient behavior could be typified as difficult. A number of 202 difficult patient cases were obtained and they were classified into 14 categories. 5 categories presented a higher frequency: a) Schedule and/or appointment timing. b) Patients not following instructions and/or altering treatment. c) Anxious patients. d) Patients unhappy with their treatment. e) Authoritarian patients or patients without good manners. This 5 categories were present in the 60% of the situations and can be taken as a model with specific behavioral characteristics as to identify the difficult patient. This is valuable in order to manage this type of patients and be successful.

  10. Orbital and Maxillofacial Computer Aided Surgery: Patient-Specific Finite Element Models To Predict Surgical Outcomes

    CERN Document Server

    Luboz, V; Swider, P; Payan, Y; Luboz, Vincent; Chabanas, Matthieu; Swider, Pascal; Payan, Yohan

    2005-01-01

    This paper addresses an important issue raised for the clinical relevance of Computer-Assisted Surgical applications, namely the methodology used to automatically build patient-specific Finite Element (FE) models of anatomical structures. From this perspective, a method is proposed, based on a technique called the Mesh-Matching method, followed by a process that corrects mesh irregularities. The Mesh-Matching algorithm generates patient-specific volume meshes from an existing generic model. The mesh regularization process is based on the Jacobian matrix transform related to the FE reference element and the current element. This method for generating patient-specific FE models is first applied to Computer-Assisted maxillofacial surgery, and more precisely to the FE elastic modelling of patient facial soft tissues. For each patient, the planned bone osteotomies (mandible, maxilla, chin) are used as boundary conditions to deform the FE face model, in order to predict the aesthetic outcome of the surgery. Seven F...

  11. Delay Efficient 32-Bit Carry-Skip Adder

    OpenAIRE

    Yu Shen Lin; Damu Radhakrishnan

    2008-01-01

    The design of a 32-bit carry-skip adder to achieve minimum delay is presented in this paper. A fast carry look-ahead logic using group generate and group propagate functions is used to speed up the performance of multiple stages of ripple carry adders. The group generate and group propagate functions are generated in parallel with the carry generation for each block. The optimum block sizes are decided by considering the critical path into account. The new architecture ...

  12. 国内外资源环境承载力模型和评价方法综述--基于内容分析法%Reviews on Resources and Environment Carrying Capacity Model and Evaluation Methods Both in China and Abroad-Based on Content Analysis

    Institute of Scientific and Technical Information of China (English)

    李华姣; 安海忠

    2013-01-01

    采用内容分析法,对国内外1991到2012年间资源环境承载力相关文献进行研究。通过搜索CNKI以及SCI和SSCI数据库,共检索并筛选得到资源环境承载力相关论文978篇(其中CNKI文献857篇,SCI、SSCI文献121篇)作为本次研究的对象。综合分析国内外承载力文献所构建和使用的模型和评价方法,其研究特点和发展趋势:从定性到定性与定量相结合;从单一到综合;从静态到动态。目前,资源环境承载力评价方法主要是以生态足迹法为主,今后,结合实际研究对象的特点,要充分运用数学、系统理论、动力学、计算机科学、计量经济学、环境学等理论,逐步建立完善的、动态的、准确的资源环境承载力评价方法和模型。%This paper researches the domestic and foreign relevant literature information about resources and environmental carryin g capacity between 1991 and 2012 based on content analysis method. And it takes 978 papers related to resources and environment carrying capacity which was sifted via searching the database of CNKI, SCI and SSCI as the subject investigated. Through comprehensive analysis of the model and evaluation method established and used by domestic and foreign literature information about resources and environmental carrying capacity, this paper introduces the characteristics and trends, these are: from qualitative to the integration of qualitative and quantitative, from single to comprehensive, from static to dynamic state. Now, ecological footprint approach dominates resources and environment carrying capacity evaluation method. In the future, we should make full use of the theory such as mathematics, systems theory, dynamics, computer science, econometrics, environmental sciences based on the trait of investigation, and gradually establish a perfect, dynamic, and accurate evaluation method and model of resource environmental bearing capacity.

  13. Engaging patients and consumers in research evidence: Applying the conceptual model of patient and family engagement.

    Science.gov (United States)

    Carman, Kristin L; Workman, Thomas A

    2017-01-01

    This essay discusses applying the Conceptual Framework for Patient and Family Engagement to partnerships with patients and consumers to increase their use of research evidence in healthcare decisions. The framework's foundational principles hold that engagement occurs on a continuum across all levels of healthcare-from direct care to policymaking-with patients and healthcare professionals working in full partnership and sharing responsibility for achieving a safe, high-quality, efficient, and patient-centered healthcare system. Research evidence can serve as a critical decision-making tool in partnerships between patients and health professionals. However, as the framework suggests, without patient and consumer engagement in the design, planning, interpretation, and dissemination of research findings, it is unlikely that the broader consumer population will find research evidence useful, much less use it, to guide their healthcare decisions. Understanding what factors influence patient and consumer engagement can lead to effective strategies that enable meaningful partnerships between patients and researchers. Understanding patient and consumer perspectives of research evidence is critical to engaging them in meaningful partnerships that produce actionable research findings that they can in turn use in partnership with health professionals to improve their own health and the healthcare system as a whole. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  14. A Modified Integrated Genetic Model for Risk Prediction in Younger Patients with Acute Myeloid Leukemia.

    Directory of Open Access Journals (Sweden)

    Caroline E Sloan

    Full Text Available Although cytogenetics-based prognostication systems are well described in acute myeloid leukemia (AML, overall survival (OS remains highly variable within risk groups. An integrated genetic prognostic (IGP model using cytogenetics plus mutations in nine genes was recently proposed for patients ≤60 years to improve classification. This model has not been validated in clinical practice.We retrospectively studied 197 patients with newly diagnosed de novo AML. We compared OS curves among the mutational profiles defined by the IGP model. The IGP model assigned patients with intermediate cytogenetics as having favorable, intermediate or unfavorable mutational profiles. The IGP model reassigned 50 of 137 patients with intermediate cytogenetics to favorable or unfavorable mutational profiles. Median OS was 2.8 years among 14 patients with intermediate cytogenetics and favorable mutational profiles (mutant NPM1 and mutant IDH1 or IDH2 and 1.3 years among patients with intermediate mutational profiles. Among patients with intermediate cytogenetics labeled as having unfavorable mutational profiles, median OS was 0.8 years among 24 patients with FLT3-ITD positive AML and high-risk genetic changes (trisomy 8, TET2 and/or DNMT3A and 1.7 years among 12 patients with FLT3-ITD negative AML and high-risk mutations (TET2, ASXL1 and/or PHF6. OS for patients with intermediate cytogenetics and favorable mutational profiles was similar to OS for patients with favorable cytogenetics (p = 0.697 and different from patients with intermediate cytogenetics and intermediate mutational profiles (p = 0.028. OS among patients with FLT3-ITD positive AML and high-risk genetic changes was similar to patients with unfavorable cytogenetics (p = 0.793 and different from patients with intermediate IGP profile (p = 0.022. Patients with FLT3-ITD negative AML and high-risk mutations, defined as 'unfavorable' in the IGP model, had OS similar to patients with intermediate IGP profile (p

  15. Interpretations of the Image of Caroline in Sister Carrie

    Institute of Scientific and Technical Information of China (English)

    钱绘

    2014-01-01

    In the history of American naturalistic literature, Sister Carrie is a representative work of this literary genre. And the protagonist of this novel Caroline has always been a controversial character. Based on Sister Carrie and the social background of that period in America, this paper discussed the various interpretations of the image of Carrie from different aspects.

  16. 46 CFR 111.105-35 - Vessels carrying coal.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Vessels carrying coal. 111.105-35 Section 111.105-35...-GENERAL REQUIREMENTS Hazardous Locations § 111.105-35 Vessels carrying coal. (a) The following are Class II, Division 1, (Zone 10 or Z) locations on a vessel that carries coal: (1) The interior of each...

  17. Modeling Patient Treatment With Medical Records: An Abstraction Hierarchy to Understand User Competencies and Needs.

    Science.gov (United States)

    St-Maurice, Justin D; Burns, Catherine M

    2017-07-28

    Health care is a complex sociotechnical system. Patient treatment is evolving and needs to incorporate the use of technology and new patient-centered treatment paradigms. Cognitive work analysis (CWA) is an effective framework for understanding complex systems, and work domain analysis (WDA) is useful for understanding complex ecologies. Although previous applications of CWA have described patient treatment, due to their scope of work patients were previously characterized as biomedical machines, rather than patient actors involved in their own care. An abstraction hierarchy that characterizes patients as beings with complex social values and priorities is needed. This can help better understand treatment in a modern approach to care. The purpose of this study was to perform a WDA to represent the treatment of patients with medical records. The methods to develop this model included the analysis of written texts and collaboration with subject matter experts. Our WDA represents the ecology through its functional purposes, abstract functions, generalized functions, physical functions, and physical forms. Compared with other work domain models, this model is able to articulate the nuanced balance between medical treatment, patient education, and limited health care resources. Concepts in the analysis were similar to the modeling choices of other WDAs but combined them in as a comprehensive, systematic, and contextual overview. The model is helpful to understand user competencies and needs. Future models could be developed to model the patient's domain and enable the exploration of the shared decision-making (SDM) paradigm. Our work domain model links treatment goals, decision-making constraints, and task workflows. This model can be used by system developers who would like to use ecological interface design (EID) to improve systems. Our hierarchy is the first in a future set that could explore new treatment paradigms. Future hierarchies could model the patient as a

  18. Validity test and its consistency in the construction of patient loyalty model

    Science.gov (United States)

    Yanuar, Ferra

    2016-04-01

    The main objective of this present study is to demonstrate the estimation of validity values and its consistency based on structural equation model. The method of estimation was then implemented to an empirical data in case of the construction the patient loyalty model. In the hypothesis model, service quality, patient satisfaction and patient loyalty were determined simultaneously, each factor were measured by any indicator variables. The respondents involved in this study were the patients who ever got healthcare at Puskesmas in Padang, West Sumatera. All 394 respondents who had complete information were included in the analysis. This study found that each construct; service quality, patient satisfaction and patient loyalty were valid. It means that all hypothesized indicator variables were significant to measure their corresponding latent variable. Service quality is the most measured by tangible, patient satisfaction is the most mesured by satisfied on service and patient loyalty is the most measured by good service quality. Meanwhile in structural equation, this study found that patient loyalty was affected by patient satisfaction positively and directly. Service quality affected patient loyalty indirectly with patient satisfaction as mediator variable between both latent variables. Both structural equations were also valid. This study also proved that validity values which obtained here were also consistence based on simulation study using bootstrap approach.

  19. Evaluation of serum levels of SOD and MDA in patients with Leber's hereditary optic neuropathy carrying the mitochondrial DNA G11778A mutation%G11778A突变型Leber遗传性视神经病变患者血清总超氧化物歧化酶活力和丙二醛含量的研究

    Institute of Scientific and Technical Information of China (English)

    刘哲; 孙传宾; 童绎; 瞿佳

    2009-01-01

    Objective To determine the serum levels of total supemxide dismutase (SOD) activity and malondialdehyde (MDA), and to evaluate the oxidant-antioxidant status in patients with Leber's hereditary optic neuropathy (LHON) carrying the mitochondrial G11778A mutation.Methods Nineteen patients and 12 carriers from three Chinese G11778A LHON families were enrolled in this study, and 30 agematched healthy volunteers were recruited as normal controls.The serum levels of total SOD activty and MDA in all subjects were measured by xanthine oxidase test and thiobarbituric acid technique, respectively. Results The serum level of total SOD activity in LHON patients was significantly less than that in carriers and normal controls (q=7.085 and 8.351, respectively,both P<0.05), however, there was no significant difference between the carriers and normal controls (q=0.269.P>0.05).The serum level of MDA in patients and carriers was significandy higher thah that in normal controls (q=9.069 and 4.748, respectively,both P<0.05),and it was also significantly higher in patients than that in carriers(q=3.618,P<0.05).Conclusions Antioxidant capacity decreased significantly in patients with LHON, which indicates that the onset of LHON waft related with the oxidation.antioxidation imbalance.%目的 检测G11778A突变型Leber遗传性视神经病变(LHON)患者血清总超氧化物歧化酶(SOD)活力和丙二醛(MDA)含量并了解LHON患者体内氧化与抗氧化状态.方法 病例对照研究.纳入经眼科检查和线粒体基因测序确诊的G11778A基因突变型LHON患者19例,G11778A基因突变携带者(携带者)12例,正常对照者30例,分别应用黄嘌呤氧化酶法和硫代巴比妥酸法检测受试者血清总SOD活力和MDA含量.应用SPSS 12.0统计学软件包.采用单因素三水平设计定量资料方差分析,分别计算LHON患者、携带者及正常对照者血清总SOD活力和MDA含量的均数及标准差,比较3组受试者间各检测指标的均

  20. Delay Efficient 32-Bit Carry-Skip Adder

    Directory of Open Access Journals (Sweden)

    Yu Shen Lin

    2008-01-01

    Full Text Available The design of a 32-bit carry-skip adder to achieve minimum delay is presented in this paper. A fast carry look-ahead logic using group generate and group propagate functions is used to speed up the performance of multiple stages of ripple carry adders. The group generate and group propagate functions are generated in parallel with the carry generation for each block. The optimum block sizes are decided by considering the critical path into account. The new architecture delivers the sum and carry outputs in lesser unit delays than existing carry-skip adders. The adder is implemented in 0.25 m CMOS technology at 3.3 V. The critical delay for the proposed adder is 3.4 nanoseconds. The simulation results show that the proposed adder is 18% faster than the current fastest carry-skip adder.

  1. Patient Specific Modeling of Head-Up Tilt

    DEFF Research Database (Denmark)

    Williams, Nakeya; Wright, Andrew; Mehlsen, Jesper;

    2014-01-01

    blood pressure. The model contains five compartments representing arteries and veins in the upper and lower body of the systemic circulation, as well as the left ventricle facilitating pumping of the heart. A physiologically based sub-model describes gravitational effects on pooling of blood during...

  2. Care model for patients with phenylketonuria (PKU in Argentina

    Directory of Open Access Journals (Sweden)

    Ana Chiesa

    2014-07-01

    1,300,000 subjects tested. Nutritional treatment consists of a diet restricted in phenylanine (Phe and free of animal food, it is started in all children whose serum Phe levels are above 6 mg/dL, low tyrosine (Tyr concentration, and a Phe to Tyr ratio >3, although patients between 2 to 6 mg/dL are closely followed. Periodic blood Phe quantification and dietetic instructions to the patient are required in order to keep Phe levels in a safe range that preserves nervous system maturing, and prevention of mental retardation which is inherent to non-treated disease. Educational activities constitute the core of the teamwork; they are destined to achieve the best psycho-social integration of the patient to society. Patients’ mothers are trained to follow dietetic quantities of Phe following the “Practical guidance for phenylketonuric patients’ nutrition”. Diet compliance is a complex process which should be evaluated in individual and familiar context in order to identify the need for extra medical support; adolescents are the most vulnerable age population. It has been noted that late diagnosed patients who were given the adequate proposed treatment improved in terms of neurological symptoms, behavioral issues as well as in their potential for rehabilitation.

  3. Modeling Outcome of Patients on Renal Replacement Therapy

    NARCIS (Netherlands)

    Y.S. Liem (Ylian Serina)

    2008-01-01

    textabstractThe incidence of end-stage renal disease is increasing and therefore, the number of patients requiring renal replacement therapy (RRT), renal dialysis or renal transplantation (RTx), has been rising. The various forms of RRT are associated with differences in survival and quality of life

  4. Carrying photosynthesis genes increases ecological fitness of cyanophage in silico.

    Science.gov (United States)

    Hellweger, Ferdi L

    2009-06-01

    Several viruses infecting marine cyanobacteria carry photosynthesis genes (e.g. psbA, hli) that are expressed, yield proteins (D1, HLIP) and help maintain the cell's photosynthesis apparatus during the latent period. This increases energy and speeds up virus production, allowing for a reduced latent period (a fitness benefit), but it also increases the DNA size, which slows down new virus production and reduces burst size (a fitness cost). How do these genes affect the net ecological fitness of the virus? Here, this question is explored using a combined systems biology and systems ecology ('systems bioecology') approach. A novel agent-based model simulates individual cyanobacteria cells and virus particles, each with their own genes, transcripts, proteins and other properties. The effect of D1 and HLIP proteins is explicitly considered using a mechanistic photosynthesis component. The model is calibrated to the available database for Prochlorococcus ecotype MED4 and podovirus P-SSP7. Laboratory- and field-scale in silico survival, competition and evolution (gene packaging error) experiments with wild type and genetically engineered viruses are performed to develop vertical survival and fitness profiles, and to determine the optimal gene content. The results suggest that photosynthesis genes are nonessential, increase fitness in a manner correlated with irradiance, and that the wild type has an optimal gene content.

  5. Human embryonic stem cells carrying mutations for severe genetic disorders.

    Science.gov (United States)

    Frumkin, Tsvia; Malcov, Mira; Telias, Michael; Gold, Veronica; Schwartz, Tamar; Azem, Foad; Amit, Ami; Yaron, Yuval; Ben-Yosef, Dalit

    2010-04-01

    Human embryonic stem cells (HESCs) carrying specific mutations potentially provide a valuable tool for studying genetic disorders in humans. One preferable approach for obtaining these cell lines is by deriving them from affected preimplantation genetically diagnosed embryos. These unique cells are especially important for modeling human genetic disorders for which there are no adequate research models. They can be further used to gain new insights into developmentally regulated events that occur during human embryo development and that are responsible for the manifestation of genetically inherited disorders. They also have great value for the exploration of new therapeutic protocols, including gene-therapy-based treatments and disease-oriented drug screening and discovery. Here, we report the establishment of 15 different mutant human embryonic stem cell lines derived from genetically affected embryos, all donated by couples undergoing preimplantation genetic diagnosis in our in vitro fertilization unit. For further information regarding access to HESC lines from our repository, for research purposes, please email dalitb@tasmc.health.gov.il.

  6. How are organisational climate models and patient satisfaction related? A competing value framework approach.

    Science.gov (United States)

    Ancarani, Alessandro; Di Mauro, Carmela; Giammanco, Maria Daniela

    2009-12-01

    Patient satisfaction has become an important indicator of process quality inside hospitals. Even so, the improvement of patient satisfaction cannot simply follow from the implementation of new incentives schemes and organisational arrangements; it also depends on hospitals' cultures and climates. This paper studies the impact of alternative models of organisational climate in hospital wards on patient satisfaction. Data gathered from seven public hospitals in Italy are used to explore this relationship. The theoretical approach adopted is the Competing Value Framework which classifies organisations according to their inward or outward focus and according to the importance assigned to control vs. flexibility. Results show that both a model stressing openness, change and innovation and a model emphasising cohesion and workers' morale are positively related to patient satisfaction, while a model based on managerial control is negatively associated with patient satisfaction.

  7. Numerical simulation for the upper airway flow characteristics of Chinese patients with OSAHS using CFD models.

    Science.gov (United States)

    Tan, Jie; Huang, Jianmin; Yang, Jianguo; Wang, Desheng; Liu, Jianzhi; Liu, Jingbo; Lin, Shuchun; Li, Chen; Lai, Haichun; Zhu, Hongyu; Hu, Xiaohua; Chen, Dongxu; Zheng, Longxiang

    2013-03-01

    OSAHS is a common disease with many factors related to the etiology. Airflow plays an important role in the pathogenesis of OSAHS. Previous research has not yielded a sufficient understanding of the relationship between airflow in upper airway and the pathophysiology of OSAHS. Therefore, a better understanding of the flow inside the upper airway in an OSAHS patient is necessary. In this study, ten Chinese adults with OSAHS were recruited. We used the software MIMICS 13.1 to construct 3-dimensional (3-D) models based on the computer tomography scans of them. The numerical simulations were carried out using the software ANSYS 12.0. We found that during the inhalation phase, the vortices and turbulences were located in both the anterior part of the cavity and nasopharynx. But there is no vortex in the whole nasal cavity during the expiratory phase. The airflow velocity is much higher than that of the normal models. The distributions of pressure and wall shear stress are different in two phases. The maximum velocity, pressure and wall shear stress (WSS) are located in velopharynx. It is notable that a strong negative pressure region is found in pharyngeal airway. The maximum velocity is 19.26 ± 12.4 and 19.46 ± 13.1 m/s; the average pressure drop is 222.71 ± 208.84 and 238.5 ± 218.56 Pa and the maximum average WSS is 0.72 ± 0.58 and 1.01 ± 0.61 Pa in inspiratory and expiratory, respectively. The changes of airflow due to the structure changes play an important role in the occurrence of collapse and obstruction of the upper airway, especially, the abnormal pressure changes in velopharyngeal during both inspiratory and expiratory phases. We can say that the airway narrowing in the pharynx may be one of the most important factors driving airway collapse. In addition, the most collapsible region of the pharyngeal airway of the patient with OSAHS may be the velopharynx and oropharynx. In spite of limitations, our results can provide a basis for the further research

  8. Time-varying respiratory system elastance: a physiological model for patients who are spontaneously breathing.

    Directory of Open Access Journals (Sweden)

    Yeong Shiong Chiew

    Full Text Available BACKGROUND: Respiratory mechanics models can aid in optimising patient-specific mechanical ventilation (MV, but the applications are limited to fully sedated MV patients who have little or no spontaneously breathing efforts. This research presents a time-varying elastance (E(drs model that can be used in spontaneously breathing patients to determine their respiratory mechanics. METHODS: A time-varying respiratory elastance model is developed with a negative elastic component (E(demand, to describe the driving pressure generated during a patient initiated breathing cycle. Data from 22 patients who are partially mechanically ventilated using Pressure Support (PS and Neurally Adjusted Ventilatory Assist (NAVA are used to investigate the physiology relevance of the time-varying elastance model and its clinical potential. E(drs of every breathing cycle for each patient at different ventilation modes are presented for comparison. RESULTS: At the start of every breathing cycle initiated by patient, E(drs is 25 cmH2Os/l and thus can be used as an acute respiratory distress syndrome (ARDS severity indicator. CONCLUSION: The E(drs model captures unique dynamic respiratory mechanics for spontaneously breathing patients with respiratory failure. The model is fully general and is applicable to both fully controlled and partially assisted MV modes.

  9. Associations of patient safety outcomes with models of nursing care organization at unit level in hospitals.

    Science.gov (United States)

    Dubois, Carl-Ardy; D'amour, Danielle; Tchouaket, Eric; Clarke, Sean; Rivard, Michèle; Blais, Régis

    2013-04-01

    To examine the associations of four distinct nursing care organizational models with patient safety outcomes. Cross-sectional correlational study. Using a standardized protocol, patients' records were screened retrospectively to detect occurrences of patient safety-related events. Binary logistic regression was used to assess the associations of those events with four nursing care organizational models. Twenty-two medical units in 11 hospitals in Quebec, Canada, were clustered into 4 nursing care organizational models: 2 professional models and 2 functional models. Two thousand six hundred and ninety-nine were patients hospitalized for at least 48 h on the selected units. Composite of six safety-related events widely-considered sensitive to nursing care: medication administration errors, falls, pneumonia, urinary tract infection, unjustified restraints and pressure ulcers. Events were ultimately sorted into two categories: events 'without major' consequences for patients and events 'with' consequences. After controlling for patient characteristics, patient risk of experiencing one or more events (of any severity) and of experiencing an event with consequences was significantly lower, by factors of 25-52%, in both professional models than in the functional models. Event rates for both functional models were statistically indistinguishable from each other. Data suggest that nursing care organizational models characterized by contrasting staffing, work environment and innovation characteristics may be associated with differential risk for hospitalized patients. The two professional models, which draw mainly on registered nurses (RNs) to deliver nursing services and reflect stronger support for nurses' professional practice, were associated with lower risks than are the two functional models.

  10. Saliva microbiota carry caries-specific functional gene signatures.

    Directory of Open Access Journals (Sweden)

    Fang Yang

    Full Text Available Human saliva microbiota is phylogenetically divergent among host individuals yet their roles in health and disease are poorly appreciated. We employed a microbial functional gene microarray, HuMiChip 1.0, to reconstruct the global functional profiles of human saliva microbiota from ten healthy and ten caries-active adults. Saliva microbiota in the pilot population featured a vast diversity of functional genes. No significant distinction in gene number or diversity indices was observed between healthy and caries-active microbiota. However, co-presence network analysis of functional genes revealed that caries-active microbiota was more divergent in non-core genes than healthy microbiota, despite both groups exhibited a similar degree of conservation at their respective core genes. Furthermore, functional gene structure of saliva microbiota could potentially distinguish caries-active patients from healthy hosts. Microbial functions such as Diaminopimelate epimerase, Prephenate dehydrogenase, Pyruvate-formate lyase and N-acetylmuramoyl-L-alanine amidase were significantly linked to caries. Therefore, saliva microbiota carried disease-associated functional signatures, which could be potentially exploited for caries diagnosis.

  11. The synergy professional practice model and its patient characteristics tool: a staff empowerment strategy.

    Science.gov (United States)

    MacPhee, Maura; Wardrop, Andrea; Campbell, Cheryl; Wejr, Patricia

    2011-10-01

    Nurse leaders can positively influence practice environments through a number of empowerment strategies, among them professional practice models. These models encompass the philosophy, structures and processes that support nurses' control over their practice and their voice within healthcare organizations. Nurse-driven professional practice models can serve as a framework for collaborative decision-making among nursing and other staff. This paper describes a provincewide pilot project in which eight nurse-led project teams in four healthcare sectors worked with the synergy professional practice model and its patient characteristics tool. The teams learned how the model and tool can be used to classify patients' acuity levels and make staffing assignments based on a "best fit" between patient needs and staff competencies. The patient characteristics tool scores patients' acuities on eight characteristics such as stability, vulnerability and resource availability. This tool can be used to make real-time patient assessments. Other potential applications for the model and tool are presented, such as care planning, team-building and determining appropriate staffing levels. Our pilot project evidence suggests that the synergy model and its patient characteristics tool may be an empowerment strategy that nursing leaders can use to enhance their practice environments.

  12. Patient specific finite element model of the face soft tissues for computer-assisted maxillofacial surgery.

    Science.gov (United States)

    Chabanas, Matthieu; Luboz, Vincent; Payan, Yohan

    2003-06-01

    This paper addresses the prediction of face soft tissue deformations resulting from bone repositioning in maxillofacial surgery. A generic 3D Finite Element model of the face soft tissues was developed. Face muscles are defined in the mesh as embedded structures, with different mechanical properties (transverse isotropy, stiffness depending on muscle contraction). Simulations of face deformations under muscle actions can thus be performed. In the context of maxillofacial surgery, this generic soft-tissue model is automatically conformed to patient morphology by elastic registration, using skin and skull surfaces segmented from a CT scan. Some elements of the patient mesh could be geometrically distorted during the registration, which disables Finite Element analysis. Irregular elements are thus detected and automatically regularized. This semi-automatic patient model generation is robust, fast and easy to use. Therefore it seems compatible with clinical use. Six patient models were successfully built, and simulations of soft tissue deformations resulting from bone displacements performed on two patient models. Both the adequation of the models to the patient morphologies and the simulations of post-operative aspects were qualitatively validated by five surgeons. Their conclusions are that the models fit the morphologies of the patients, and that the predicted soft tissue modifications are coherent with what they would expect.

  13. Genomic characterization of patient-derived xenograft models established from fine needle aspirate biopsies of a primary pancreatic ductal adenocarcinoma and from patient-matched metastatic sites

    OpenAIRE

    Allaway, Robert J.; Fischer, Dawn A.; de Abreu, Francine B.; Gardner, Timothy B.; Gordon, Stuart R.; Barth, Richard J.; Colacchio, Thomas A.; Wood, Matthew; Kacsoh, Balint Z.; Bouley, Stephanie J.; Cui, Jingxuan; Hamilton, Joanna; Choi, Jungbin A.; Lange, Joshua T.; Peterson, Jason D.

    2016-01-01

    N-of-1 trials target actionable mutations, yet such approaches do not test genomically-informed therapies in patient tumor models prior to patient treatment. To address this, we developed patient-derived xenograft (PDX) models from fine needle aspiration (FNA) biopsies (FNA-PDX) obtained from primary pancreatic ductal adenocarcinoma (PDAC) at the time of diagnosis. Here, we characterize PDX models established from one primary and two metastatic sites of one patient. We identified an activatin...

  14. Risk Analysis on Groundwater Resources Carrying Capacity Based on Blind Number Theory

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ji; YU Sujun

    2007-01-01

    Blind numbers of evaluation indices about groundwater resources carrying capacity are defined from the concomitancy of randomness, fuzziness, grey property and unascertainment of groundwater system.Based on fuzzy theory, a comprehensive evaluation model on groundwaterresources carrying capacity is constructed with blind information. Then arisk assessment model of surcharge about groundwater resources carryingcapacity is established on blind reliability theory. The probable value"*"'matrix of fuzzy membership degree about carrying capacity corresponding to each judgment level can be obtained with the aid of blind algorithm as well as the subjective reliability "×" matrix. And then a graph of"groundwater carrying capacity v.s. accumulative reliability" can be gained.Based on the graph, fuzzy membership degree of groundwater resourcescarrying capacity to each judgment level under different risk probabilitycan be got. Thus, a comparatively reasonable judgment to groundwaterresources carrying capacity might be obtained, with comprehensive analysis to the state of society, economy technology and ecology.

  15. Using conjoint analysis to model the preferences of different patient segments for attributes of patient-centered care.

    Science.gov (United States)

    Cunningham, Charles E; Deal, Ken; Rimas, Heather; Campbell, Heather; Russell, Ann; Henderson, Jennifer; Matheson, Anne; Melnick, Blake

    2008-12-01

    A consensus regarding the components of a patient-centered approach to healthcare does not exist. Although patient-centered care should be predicated on patient preferences, existing models provide little evidence regarding the relative importance of different care processes to patients themselves. To involve patients in the design of a model of patient-centered care for a corporation of Canadian teaching hospitals. Using themes from focus groups and interviews, a conjoint survey was developed comprising 14 four-level patient-centered care attributes. Sawtooth Software's Choice Based Conjoint module (version 2.6.7) was used to design the survey. Each participant completed 15 choice tasks, each task presenting a choice between three hospitals described by a different combination of patient-centered care attribute levels. Latent class analysis was used to identify segments of participants with similar patient-centered care choice patterns. Randomized First Choice simulations were used to predict the percentage of participants in each segment who would choose different approaches to improving patient-centered care.Representative hospital service users were recruited from a corporation of five Canadian teaching hospitals serving a regional population of 2.2 million. A total of 508 patients and family members of children completed a choice-based conjoint survey. Latent class analysis revealed two segments: an informed care segment and a convenient care segment. Participants in the informed care segment (71.3% of the sample) were more likely to have higher education, be non-immigrants, speak English as a first language, and be outpatients or family members.The information needed to understand health concerns, an opportunity to learn health improvement skills, teams that communicated effectively, short waiting times, and collaborative treatment planning were more important to the informed care segment than to the convenient care segment. Convenient settings, a welcoming

  16. Existing general population models inaccurately predict lung cancer risk in patients referred for surgical evaluation.

    Science.gov (United States)

    Isbell, James M; Deppen, Stephen; Putnam, Joe B; Nesbitt, Jonathan C; Lambright, Eric S; Dawes, Aaron; Massion, Pierre P; Speroff, Theodore; Jones, David R; Grogan, Eric L

    2011-01-01

    Patients undergoing resections for suspicious pulmonary lesions have a 9% to 55% benign rate. Validated prediction models exist to estimate the probability of malignancy in a general population and current practice guidelines recommend their use. We evaluated these models in a surgical population to determine the accuracy of existing models to predict benign or malignant disease. We conducted a retrospective review of our thoracic surgery quality improvement database (2005 to 2008) to identify patients who underwent resection of a pulmonary lesion. Patients were stratified into subgroups based on age, smoking status, and fluorodeoxyglucose positron emission tomography (PET) results. The probability of malignancy was calculated for each patient using the Mayo and solitary pulmonary nodules prediction models. Receiver operating characteristic and calibration curves were used to measure model performance. A total of 189 patients met selection criteria; 73% were malignant. Patients with preoperative PET scans were divided into four subgroups based on age, smoking history, and nodule PET avidity. Older smokers with PET-avid lesions had a 90% malignancy rate. Patients with PET-nonavid lesions, PET-avid lesions with age less than 50 years, or never smokers of any age had a 62% malignancy rate. The area under the receiver operating characteristic curve for the Mayo and solitary pulmonary nodules models was 0.79 and 0.80, respectively; however, the models were poorly calibrated (p<0.001). Despite improvements in diagnostic and imaging techniques, current general population models do not accurately predict lung cancer among patients referred for surgical evaluation. Prediction models with greater accuracy are needed to identify patients with benign disease to reduce nontherapeutic resections. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Concordant but Varied Phenotypes among Duchenne Muscular Dystrophy Patient-Specific Myoblasts Derived using a Human iPSC-Based Model

    Directory of Open Access Journals (Sweden)

    In Young Choi

    2016-06-01

    Full Text Available Duchenne muscular dystrophy (DMD remains an intractable genetic disease. Althogh there are several animal models of DMD, there is no human cell model that carries patient-specific DYSTROPHIN mutations. Here, we present a human DMD model using human induced pluripotent stem cells (hiPSCs. Our model reveals concordant disease-related phenotypes with patient-dependent variation, which are partially reversed by genetic and pharmacological approaches. Our “chemical-compound-based” strategy successfully directs hiPSCs into expandable myoblasts, which exhibit a myogenic transcriptional program, forming striated contractile myofibers and participating in muscle regeneration in vivo. DMD-hiPSC-derived myoblasts show disease-related phenotypes with patient-to-patient variability, including aberrant expression of inflammation or immune-response genes and collagens, increased BMP/TGFβ signaling, and reduced fusion competence. Furthermore, by genetic correction and pharmacological “dual-SMAD” inhibition, the DMD-hiPSC-derived myoblasts and genetically corrected isogenic myoblasts form “rescued” multi-nucleated myotubes. In conclusion, our findings demonstrate the feasibility of establishing a human “DMD-in-a-dish” model using hiPSC-based disease modeling.

  18. Genetic Programming Modeling and Complexity Analysis of the Magnetoencephalogram of Epileptic Patients

    Science.gov (United States)

    Georgopoulos, Efstratios F.; Adamopoulos, Adam V.; Likothanassis, Spiridon D.

    In this work MagnetoEncephaloGram (MEG) recordings of epileptic patients are modeled using a genetic programming approach. This is the first time that genetic programming is used to model MEG signal. Numerous experiments were conducted giving highly successful results. It is demonstrated that genetic programming can produce very simple nonlinear models that fit with great accuracy the observed data of MEG.

  19. A teaching skills assessment tool inspired by the Calgary-Cambridge model and the patient-centered approach.

    Science.gov (United States)

    Sommer, Johanna; Lanier, Cédric; Perron, Noelle Junod; Nendaz, Mathieu; Clavet, Diane; Audétat, Marie-Claude

    2016-04-01

    The aim of this study was to develop a descriptive tool for peer review of clinical teaching skills. Two analogies framed our research: (1) between the patient-centered and the learner-centered approach; (2) between the structures of clinical encounters (Calgary-Cambridge communication model) and teaching sessions. During the course of one year, each step of the action research was carried out in collaboration with twelve clinical teachers from an outpatient general internal medicine clinic and with three experts in medical education. The content validation consisted of a literature review, expert opinion and the participatory research process. Interrater reliability was evaluated by three clinical teachers coding thirty audiotaped standardized learner-teacher interactions. This tool contains sixteen items covering the process and content of clinical supervisions. Descriptors define the expected teaching behaviors for three levels of competence. Interrater reliability was significant for eleven items (Kendall's coefficient pteaching skills. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Comprehensive care of amyotrophic lateral sclerosis patients: a care model.

    Science.gov (United States)

    Güell, Maria Rosa; Antón, Antonio; Rojas-García, Ricardo; Puy, Carmen; Pradas, Jesus

    2013-12-01

    Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that presents with muscle weakness, causing progressive difficulty in movement, communication, eating and ultimately, breathing, creating a growing dependence on family members and other carers. The ideal way to address the problems associated with the disease, and the decisions that must be taken, is through multidisciplinary teams. The key objectives of these teams are to optimise medical care, facilitate communication between team members, and thus to improve the quality of care. In our centre, we have extensive experience in the care of patients with ALS through an interdisciplinary team whose aim is to ensure proper patient care from the hospital to the home setting. In this article, we describe the components of the team, their roles and our way of working.

  1. Uterus Transplantation: Potential Patients, Fertility in Animal Models and Ethics

    Directory of Open Access Journals (Sweden)

    Díaz-García C

    2013-01-01

    Full Text Available Uterus transplantation (UTx has been suggested as an alternative to surrogacy to achieve genetic motherhood. Extensive experimental research must be done before any kind of transplantation moves to the clinical field in order to guarantee its safety and effectiveness. Since the final aim of this kind of transplantation is to accomplish motherhood, the success of UTx should be evaluated not only in terms of organ/patient survival but also in terms of functionality, which means that full-term pregnancies with healthy offspring should be considered as the measure of success. In this review we summarize the experimental studies accomplished during the last decade, using fertility as the main outcome, which we consider as the base for further development of UTx towards a clinical setting. Characteristics of potential patients and ethical concerns are also discussed.

  2. Uterus Transplantation: Potential Patients, Fertility in Animal Models and Ethics

    OpenAIRE

    2013-01-01

    Uterus transplantation (UTx) has been suggested as an alternative to surrogacy to achieve genetic motherhood. Extensive experimental research must be done before any kind of transplantation moves to the clinical field in order to guarantee its safety and effectiveness. Since the final aim of this kind of transplantation is to accomplish motherhood, the success of UTx should be evaluated not only in terms of organ/patient survival but also in terms of functionality, which means that full-term ...

  3. Analysis of Patient Information: An Empirical Modeling Approach

    Science.gov (United States)

    2006-03-01

    migraine headaches, epileptic seizures, and cerebral palsy [National Institutes of Health 2006]. Stroke is defined as rapidly developed clinical... exercise better control over their operations. Because it is often related to total costs, managing patient length-of-stay (LOS) has become the main...signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death. Though its cause has yet to be

  4. The tidal model. The healing potential of metaphor within a patient's narrative.

    Science.gov (United States)

    Barker, Phil

    2002-07-01

    1. The human experience of growth and development is a fluid phenomenon, occurring in small, barely visible changes. 2. The Tidal Model embraces a patient's expression of his or her experience by focusing on the lived experience of the narrative and its personally meaningful metaphors and symbols. 3. To re-empower a patient, the Tidal Model assessment is written in the patient's own voice and all care planning is conducted conjointly. 4. The Tidal Model was developed from empirical studies of the perceived need for nursing and the process of empowerment in clinical nursing practice.

  5. A model-based 3D patient-specific pre-treatment QA method for VMAT using the EPID

    Science.gov (United States)

    McCowan, P. M.; Asuni, G.; van Beek, T.; van Uytven, E.; Kujanpaa, K.; McCurdy, B. M. C.

    2017-02-01

    This study reports the development and validation of a model-based, 3D patient dose reconstruction method for pre-treatment quality assurance using EPID images. The method is also investigated for sensitivity to potential MLC delivery errors. Each cine-mode EPID image acquired during plan delivery was processed using a previously developed back-projection dose reconstruction model providing a 3D dose estimate on the CT simulation data. Validation was carried out using 24 SBRT-VMAT patient plans by comparing: (1) ion chamber point dose measurements in a solid water phantom, (2) the treatment planning system (TPS) predicted 3D dose to the EPID reconstructed 3D dose in a solid water phantom, and (3) the TPS predicted 3D dose to the EPID and our forward predicted reconstructed 3D dose in the patient (CT data). AAA and AcurosXB were used for TPS predictions. Dose distributions were compared using 3%/3 mm (95% tolerance) and 2%/2 mm (90% tolerance) γ-tests in the planning target volume (PTV) and 20% dose volumes. The average percentage point dose differences between the ion chamber and the EPID, AcurosXB, and AAA were 0.73  ±  1.25%, 0.38  ±  0.96% and 1.06  ±  1.34% respectively. For the patient (CT) dose comparisons, seven (3%/3 mm) and nine (2%/2 mm) plans failed the EPID versus AAA. All plans passed the EPID versus Acuros XB and the EPID versus forward model γ-comparisons. Four types of MLC sensitive errors (opening, shifting, stuck, and retracting), of varying magnitude (0.2, 0.5, 1.0, 2.0 mm), were introduced into six different SBRT-VMAT plans. γ-comparisons of the erroneous EPID dose and original predicted dose were carried out using the same criteria as above. For all plans, the sensitivity testing using a 3%/3 mm γ-test in the PTV successfully determined MLC errors on the order of 1.0 mm, except for the single leaf retraction-type error. A 2%/2 mm criteria produced similar results with two more additional detected

  6. Modeling of Recovery Profiles in Mentally Disabled and Intact Patients after Sevoflurane Anesthesia; A Pharmacodynamic Analysis

    Science.gov (United States)

    Shin, Teo Jeon; Noh, Gyu-Jeong; Koo, Yong-Seo

    2014-01-01

    Purpose Mentally disabled patients show different recovery profiles compared to normal patients after general anesthesia. However, the relationship of dose-recovery profiles of mentally disabled patients has never been compared to that of normal patients. Materials and Methods Twenty patients (10 mentally disabled patients and 10 mentally intact patients) scheduled to dental surgery under general anesthesia was recruited. Sevoflurane was administered to maintain anesthesia during dental treatment. At the end of the surgery, sevoflurane was discontinued. End-tidal sevoflurane and recovery of consciousness (ROC) were recorded after sevoflurane discontinuation. The pharmacodynamic relation between the probability of ROC and end-tidal sevoflurane concentration was analyzed using NONMEM software (version VII). Results End-tidal sevoflurane concentration associated with 50% probability of ROC (C50) and γ value were lower in the mentally disabled patients (C50=0.37 vol %, γ=16.5 in mentally intact patients, C50=0.19 vol %, γ=4.58 in mentally disabled patients). Mentality was a significant covariate of C50 for ROC and γ value to pharmacodynamic model. Conclusion A sigmoid Emanx model explains the pharmacodynamic relationship between end-tidal sevoflurane concentration and ROC. Mentally disabled patients may recover slower from anesthesia at lower sevoflurane concentration at ROC an compared to normal patients. PMID:25323901

  7. A Prognostic Model for One-year Mortality in Patients Requiring Prolonged Mechanical Ventilation

    Science.gov (United States)

    Carson, Shannon S.; Garrett, Joanne; Hanson, Laura C.; Lanier, Joyce; Govert, Joe; Brake, Mary C.; Landucci, Dante L.; Cox, Christopher E.; Carey, Timothy S.

    2009-01-01

    Objective A measure that identifies patients who are at high risk of mortality after prolonged ventilation will help physicians communicate prognosis to patients or surrogate decision-makers. Our objective was to develop and validate a prognostic model for 1-year mortality in patients ventilated for 21 days or more. Design Prospective cohort study. Setting University-based tertiary care hospital Patients 300 consecutive medical, surgical, and trauma patients requiring mechanical ventilation for at least 21 days were prospectively enrolled. Measurements and Main Results Predictive variables were measured on day 21 of ventilation for the first 200 patients and entered into logistic regression models with 1-year and 3-month mortality as outcomes. Final models were validated using data from 100 subsequent patients. One-year mortality was 51% in the development set and 58% in the validation set. Independent predictors of mortality included requirement for vasopressors, hemodialysis, platelet count ≤150 ×109/L, and age ≥50. Areas under the ROC curve for the development model and validation model were 0.82 (se 0.03) and 0.82 (se 0.05) respectively. The model had sensitivity of 0.42 (se 0.12) and specificity of 0.99 (se 0.01) for identifying patients who had ≥90% risk of death at 1 year. Observed mortality was highly consistent with both 3- and 12-month predicted mortality. These four predictive variables can be used in a simple prognostic score that clearly identifies low risk patients (no risk factors, 15% mortality) and high risk patients (3 or 4 risk factors, 97% mortality). Conclusions Simple clinical variables measured on day 21 of mechanical ventilation can identify patients at highest and lowest risk of death from prolonged ventilation. PMID:18552692

  8. Effect of patient location on the performance of clinical models to predict pulmonary embolism.

    Science.gov (United States)

    Ollenberger, Glenn P; Worsley, Daniel F

    2006-01-01

    Current clinical likelihood models for predicting pulmonary embolism (PE) are used to categorize outpatients into low, intermediate and high clinical pre-test likelihood of PE. Since these clinical prediction rules were developed using outpatients it is not known if they can be applied universally to both inpatients and outpatients with suspected PE. Thus, the purpose of this study was to determine the effect of patient location on the performance of clinical models to predict PE. Two clinical models (Wells and Wicki) were applied to data from the multi-centered PIOPED study. The Wells score was applied to 1359 patients and the Wicki score was applied to 998 patients. 361 patients (27%) from the PIOPED study did not have arterial gas measurement and were excluded from the Wicki score patient group. Patients were stratified by their location at the time of entry into the PIOPED study as follows: outpatient/emergency, surgical ward, medicine/coronary care unit or intensive care unit. The diagnostic performance of the two clinical models was applied to the various patient locations and the performance was evaluated using the area under a fitted receiver operating characteristic curve (AUC). The prevalence of PE in the three clinical probability categories were similar for the two scoring methods. Both clinical models yielded the lowest diagnostic performance in patients referred from surgical wards. The AUC for both clinical prediction rules decreased significantly when applied to inpatients in comparison to outpatients. Current clinical prediction rules for determining the pre-test likelihood of PE yielded different diagnostic performances depending upon patient location. The performance of the clinical prediction rules decreased significantly when applied to inpatients. In particular, the rules performed least well when applied to patients referred from surgical wards suggesting these rules should not be used in this patient group. As expected the clinical

  9. High performance pipelined multiplier with fast carry-save adder

    Science.gov (United States)

    Wu, Angus

    1990-01-01

    A high-performance pipelined multiplier is described. Its high performance results from the fast carry-save adder basic cell which has a simple structure and is suitable for the Gate Forest semi-custom environment. The carry-save adder computes the sum and carry within two gate delay. Results show that the proposed adder can operate at 200 MHz for a 2-micron CMOS process; better performance is expected in a Gate Forest realization.

  10. Trusted Module Acquisition Through Proof-Carrying Hardware Intellectual Property

    Science.gov (United States)

    2015-05-22

    hardware intellectual property (PCHIP) framework, which aims to ensure the trustworthiness of third-party hardware IPs utilizing formal methods. We...published in non peer-reviewed journals: Final Report: Trusted Module Acquisition Through Proof-Carrying Hardware Intellectual Property Report Title By...borrowing ideas from the proof carrying code (PCC) in software domain, in this project we introduced the proof carrying hardware intellectual property

  11. Optimal design method for fast carry-skip adders

    Science.gov (United States)

    Lee, Songjun; Swartzlander, Earl E., Jr.

    2001-11-01

    A carry-skip adder is faster than a ripple carry adder and it has a simple structure. To maximize the speed it is necessary to optimize the width of the blocks that comprise the carry skip adder. This paper presents a simple algorithm to select the size of each block. Assuming that each logic gate has a unit delay, the algorithm achieves slightly faster designs for 64 and 128 bit adders than previous methods developed by Guyot, et al. and Kantabutra.

  12. Assessing Predictive Performance of Published Population Pharmacokinetic Models of Intravenous Tobramycin in Pediatric Patients.

    Science.gov (United States)

    Bloomfield, Celeste; Staatz, Christine E; Unwin, Sean; Hennig, Stefanie

    2016-06-01

    Several population pharmacokinetic models describe the dose-exposure relationship of tobramycin in pediatric patients. Before the implementation of these models in clinical practice for dosage adjustment, their predictive performance should be externally evaluated. This study tested the predictive performance of all published population pharmacokinetic models of tobramycin developed for pediatric patients with an independent patient cohort. A literature search was conducted to identify suitable models for testing. Demographic and pharmacokinetic data were collected retrospectively from the medical records of pediatric patients who had received intravenous tobramycin. Tobramycin exposure was predicted from each model. Predictive performance was assessed by visual comparison of predictions to observations, by calculation of bias and imprecision, and through the use of simulation-based diagnostics. Eight population pharmacokinetic models were identified. A total of 269 concentration-time points from 41 pediatric patients with cystic fibrosis were collected for external evaluation. Three models consistently performed best in all evaluations and had mean errors ranging from -0.4 to 1.8 mg/liter, relative mean errors ranging from 4.9 to 29.4%, and root mean square errors ranging from 47.8 to 66.9%. Simulation-based diagnostics supported these findings. Models that allowed a two-compartment disposition generally had better predictive performance than those that used a one-compartment disposition model. Several published models of the pharmacokinetics of tobramycin showed reasonable low levels of bias, although all models seemed to have some problems with imprecision. This suggests that knowledge of typical pharmacokinetic behavior and patient covariate values alone without feedback concentration measurements from individual patients is not sufficient to make precise predictions. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  13. Organization and carrying out the triathlon competitions in Ukraine

    Directory of Open Access Journals (Sweden)

    Volodymyr Vodlozerov

    2016-02-01

    Full Text Available Purpose: the aim is analyzing of system of organization and carrying out the triathlon competitions in Ukraine in accordance with rules of triathlon international federation. Material & Methods: comparative analysis of process of organization and carrying out the triathlon competitions in the world and Ukraine was carried out on basis of specialist literature studying, normative base of sports organizations (triathlon federation. Results: inconsistencies were identified in competitions carried out in cold season, particularity of triathlon that intends overcoming the combined distance without time durations between stages. Conclusions: recommendation in eliminate inconsistencies that affect to performance of triathlon competitions in Ukraine was suggested.

  14. Magnetically Guiding Atoms with Current-Carrying Conductors

    Institute of Scientific and Technical Information of China (English)

    刘南春; 高伟建; 印建平

    2002-01-01

    We propose a novel magnetic guide for cold neutral atoms using some current-carrying conductors. The spatial distributions of the magnetic fields from a V-shaped or U-shaped current-carrying conductor are calculated, and the relationship between the resulting magnetic field and the parameters of the current-carrying conductors is analysed in detail. The result shows that these current-carrying conductors can be used to realize a single or a controllable double magnetic guide of cold atoms in the weak-field-seeking state, and to construct various atom-optical elements, and even to realize a single-mode atomic waveguiding under certain conditions.

  15. [Factor models of the Beck Depression Inventory-II. Validation with coronary patients and a critique of Ward's model].

    Science.gov (United States)

    del Pino Pérez, Antonio; Ibáñez Fernández, Ignacio; Bosa Ojeda, Francisco; Dorta González, Ruth; Gaos Miezoso, María Teresa

    2012-02-01

    The objective of this study was to validate in a sample of 205 coronary patients a factor model for the BDI-II, especially a model that would allow for modeling of depressive symptoms after explicitly removing bias related to somatic symptoms of depression that would overlap those of heart disease. Exploratory and confirmatory factor analyses for ordinal data were conducted. A one-factor model, six correlated two-factor models and, derivatives thereof, seven models with a single General Depression factor and two uncorrelated factors, were analyzed. Exploratory analysis extracted two factors, Somatic-affective and Cognitive. Confirmatory factor analyses showed the worst fit for the one-factor model. Two-factor models were surpassed in goodness of fit by the models of general-factor and group factors. Among these, the General, Somatic-affective and Cognitive (G-Sa-C) model of Beck with students is noteworthy. The reduced General, Somatic and Cognitive (G-S-C) model of Ward showed the worst goodness of fit. Our model surpasses the cutoff criteria of all fit indexes. We conclude that the inclusion of a general-factor and group factors in all the models surpasses the results of G-S-C model and, therefore, questions it. The G-Sa-C model is strengthened.

  16. Genomic characterization of explant tumorgraft models derived from fresh patient tumor tissue

    Directory of Open Access Journals (Sweden)

    Monsma David J

    2012-06-01

    Full Text Available Abstract Background There is resurgence within drug and biomarker development communities for the use of primary tumorgraft models as improved predictors of patient tumor response to novel therapeutic strategies. Despite perceived advantages over cell line derived xenograft models, there is limited data comparing the genotype and phenotype of tumorgrafts to the donor patient tumor, limiting the determination of molecular relevance of the tumorgraft model. This report directly compares the genomic characteristics of patient tumors and the derived tumorgraft models, including gene expression, and oncogenic mutation status. Methods Fresh tumor tissues from 182 cancer patients were implanted subcutaneously into immune-compromised mice for the development of primary patient tumorgraft models. Histological assessment was performed on both patient tumors and the resulting tumorgraft models. Somatic mutations in key oncogenes and gene expression levels of resulting tumorgrafts were compared to the matched patient tumors using the OncoCarta (Sequenom, San Diego, CA and human gene microarray (Affymetrix, Santa Clara, CA platforms respectively. The genomic stability of the established tumorgrafts was assessed across serial in vivo generations in a representative subset of models. The genomes of patient tumors that formed tumorgrafts were compared to those that did not to identify the possible molecular basis to successful engraftment or rejection. Results Fresh tumor tissues from 182 cancer patients were implanted into immune-compromised mice with forty-nine tumorgraft models that have been successfully established, exhibiting strong histological and genomic fidelity to the originating patient tumors. Comparison of the transcriptomes and oncogenic mutations between the tumorgrafts and the matched patient tumors were found to be stable across four tumorgraft generations. Not only did the various tumors retain the differentiation pattern, but supporting

  17. The Association Between Weapon Carrying and Health Risk Behaviors Among Adolescent Students in Bangkok, Thailand.

    Science.gov (United States)

    Saiphoklang, On-Anong; Wongboonsin, Kua; Wongboonsin, Patcharawalai; Perngparn, Usaneya; Cottler, Linda B

    2015-07-30

    Carrying weapons is a significant social and public health problem worldwide, especially among adolescents. The present study examined the association between weapon carrying and related risk behaviors among Thai adolescents. A cross-sectional study of 2,588 high school and vocational school students aged 11 to 19 years from 26 schools in Bangkok, Thailand, was conducted in 2014. This study found that 7.8% of youth reported having carried a weapon in the past 12 months. The high prevalence of weapon carrying was reported by male students, and males were more likely to have reported carrying a weapon than females. The association between weapon carrying and the health risk behaviors like drinking, smoking, any drug use, and physical fighting were significant with higher odds of weapon carrying in all models. Among males, weapon carrying was related to drinking and smoking, any drug use, physical fighting, and school type. Among females, suicidal thoughts were significantly related along with drinking and smoking, any drug use, and physical fighting. Having a mother who used substances was significant only among females. These data could be used for further interventions about weapon carrying to reduce violence. © The Author(s) 2015.

  18. An emergency department patient flow model based on queueing theory principles.

    Science.gov (United States)

    Wiler, Jennifer L; Bolandifar, Ehsan; Griffey, Richard T; Poirier, Robert F; Olsen, Tava

    2013-09-01

    The objective was to derive and validate a novel queuing theory-based model that predicts the effect of various patient crowding scenarios on patient left without being seen (LWBS) rates. Retrospective data were collected from all patient presentations to triage at an urban, academic, adult-only emergency department (ED) with 87,705 visits in calendar year 2008. Data from specific time windows during the day were divided into derivation and validation sets based on odd or even days. Patient records with incomplete time data were excluded. With an established call center queueing model, input variables were modified to adapt this model to the ED setting, while satisfying the underlying assumptions of queueing theory. The primary aim was the derivation and validation of an ED flow model. Chi-square and Student's t-tests were used for model derivation and validation. The secondary aim was estimating the effect of varying ED patient arrival and boarding scenarios on LWBS rates using this model. The assumption of stationarity of the model was validated for three time periods (peak arrival rate = 10:00 a.m. to 12:00 p.m.; a moderate arrival rate = 8:00 a.m. to 10:00 a.m.; and lowest arrival rate = 4:00 a.m. to 6:00 a.m.) and for different days of the week and month. Between 10:00 a.m. and 12:00 p.m., defined as the primary study period representing peak arrivals, 3.9% (n = 4,038) of patients LWBS. Using the derived model, the predicted LWBS rate was 4%. LWBS rates increased as the rate of ED patient arrivals, treatment times, and ED boarding times increased. A 10% increase in hourly ED patient arrivals from the observed average arrival rate increased the predicted LWBS rate to 10.8%; a 10% decrease in hourly ED patient arrivals from the observed average arrival rate predicted a 1.6% LWBS rate. A 30-minute decrease in treatment time from the observed average treatment time predicted a 1.4% LWBS. A 1% increase in patient arrivals has the same effect on LWBS rates as a 1

  19. Certificate size reduction in Abstraction-Carrying Code

    CERN Document Server

    Albert, Elvira; Puebla, Germán; Hermenegildo, Manuel

    2010-01-01

    Carrying Code (ACC) has recently been proposed as a framework for mobile code safety in which the code supplier provides a program together with an abstraction (or abstract model of the program) whose validity entails compliance with a predefined safety policy. The advantage of providing a (fixpoint) abstraction to the code consumer is that its validity is checked in a single pass (i.e., one iteration) of an abstract interpretation-based checker. A main challenge to make ACC useful in practice is to reduce the size of certificates as much as possible while at the same time not increasing checking time. The intuitive idea is to only include in the certificate information that the checker is unable to reproduce without iterating. We introduce the notion of reduced certificate which characterizes the subset of the abstraction which a checker needs in order to validate (and re-construct) the full certificate in a single pass. Based on this notion, we instrument a generic analysis algorithm with the necessary exte...

  20. Radar imaging using electromagnetic wave carrying orbital angular momentum

    Science.gov (United States)

    Yuan, Tiezhu; Cheng, Yongqiang; Wang, Hongqiang; Qin, Yuliang; Fan, Bo

    2017-03-01

    The concept of radar imaging based on orbital angular momentum (OAM) modulation, which has the ability of azimuthal resolution without relative motion, has recently been proposed. We investigate this imaging technique further in greater detail. We first analyze the principle of the technique, accounting for its resolving ability physically. The phase and intensity distributions of the OAM-carrying fields produced by phased uniform circular array antenna, which have significant effects on the imaging results, are investigated. The imaging model shows that the received signal has the form of inverse discrete Fourier transform with the use of OAM and frequency diversities. The two-dimensional Fourier transform is employed to reconstruct the target images in the case of large and small elevation angles. Due to the peculiar phase and intensity characteristics, the small elevation is more suitable for practical application than the large one. The minimum elevation angle is then obtained given the array parameters. The imaging capability is analyzed by means of the point spread function. All results are verified through numerical simulations. The proposed staring imaging technique can achieve extremely high azimuthal resolution with the use of plentiful OAM modes.

  1. Multilevel latent class casemix modelling: a novel approach to accommodate patient casemix

    Directory of Open Access Journals (Sweden)

    Forman David

    2011-03-01

    Full Text Available Abstract Background Using routinely collected patient data we explore the utility of multilevel latent class (MLLC models to adjust for patient casemix and rank Trust performance. We contrast this with ranks derived from Trust standardised mortality ratios (SMRs. Methods Patients with colorectal cancer diagnosed between 1998 and 2004 and resident in Northern and Yorkshire regions were identified from the cancer registry database (n = 24,640. Patient age, sex, stage-at-diagnosis (Dukes, and Trust of diagnosis/treatment were extracted. Socioeconomic background was derived using the Townsend Index. Outcome was survival at 3 years after diagnosis. MLLC-modelled and SMR-generated Trust ranks were compared. Results Patients were assigned to two classes of similar size: one with reasonable prognosis (63.0% died within 3 years, and one with better prognosis (39.3% died within 3 years. In patient class one, all patients diagnosed at stage B or C died within 3 years; in patient class two, all patients diagnosed at stage A, B or C survived. Trusts were assigned two classes with 51.3% and 53.2% of patients respectively dying within 3 years. Differences in the ranked Trust performance between the MLLC model and SMRs were all within estimated 95% CIs. Conclusions A novel approach to casemix adjustment is illustrated, ranking Trust performance whilst facilitating the evaluation of factors associated with the patient journey (e.g. treatments and factors associated with the processes of healthcare delivery (e.g. delays. Further research can demonstrate the value of modelling patient pathways and evaluating healthcare processes across provider institutions.

  2. Bilinear models for inter- and intra-patient variation of the prostate

    Science.gov (United States)

    Jeong, Y.; Radke, R. J.; Lovelock, D. M.

    2010-07-01

    We propose bilinear models for capturing and effectively decoupling the expected shape variations of an organ both across the patient population and within a specific patient. Bilinear models have been successfully introduced in other areas of computer vision, but they have rarely been used in medical imaging applications. Our particular interest is in modeling the shape variation of the prostate for potential use in radiation therapy treatment planning. Using a dataset of 204 prostate shapes contoured from CT imagery of 12 different patients, we build bilinear models and show that they can fit both training and testing shapes accurately. We also show how the bilinear model can adapt to a new patient using only a few example shapes, producing a patient-specific model that also reflects expected content variation learnt from a broader population. Finally, we evaluate the training and testing projection error, adaptation performance and image segmentation accuracy of the bilinear model compared to linear principal component analysis and hierarchical point distribution models with the same number of parameters. A preliminary version of this paper appeared in the 2006 IEEE Workshop on Mathematical Methods in Biomedical Image Analysis (Jeong and Radke 2006).

  3. Bilinear models for inter- and intra-patient variation of the prostate

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Y [School of Electrical Engineering, Pusan National University, 30 Jangjeon-dong, Geumjeong-gu, Busan 609-735 (Korea, Republic of); Radke, R J [Department of Electrical, Computer, and Systems Engineering, Rensselaer Polytechnic Institute, Troy, NY 12180 (United States); Lovelock, D M, E-mail: jeongy@pusan.ac.k [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (United States)

    2010-07-07

    We propose bilinear models for capturing and effectively decoupling the expected shape variations of an organ both across the patient population and within a specific patient. Bilinear models have been successfully introduced in other areas of computer vision, but they have rarely been used in medical imaging applications. Our particular interest is in modeling the shape variation of the prostate for potential use in radiation therapy treatment planning. Using a dataset of 204 prostate shapes contoured from CT imagery of 12 different patients, we build bilinear models and show that they can fit both training and testing shapes accurately. We also show how the bilinear model can adapt to a new patient using only a few example shapes, producing a patient-specific model that also reflects expected content variation learnt from a broader population. Finally, we evaluate the training and testing projection error, adaptation performance and image segmentation accuracy of the bilinear model compared to linear principal component analysis and hierarchical point distribution models with the same number of parameters.

  4. The Effect of Orem's Self-Care Model on Quality of Life in Patients with Migraine: a Randomized Clinical Trial.

    Science.gov (United States)

    Mahmoudzadeh Zarandi, Fatemeh; Raiesifar, Afsaneh; Ebadi, Abbas

    2016-03-01

    Many aspects of the lives of migraineurs are commonly affected by the condition, including occupational affairs, social and family life, responsibilities and ultimately the quality of life. This study was designed to determine the effect of orem's self-care nursing model on quality of life in patients with a migraine. This study was carried out in Tehran, Iran. According to the pre-post design of the randomized clinical trial, 88 patients were selected. After obtaining approval from the ethics committee of the Baqiyatallah Medical Sciences University's Research Deputy; Patients who signed the informed consent aged 20-55 years and without any more disease or disability affecting the quality of life were selected and randomly assigned to a group. Data collection tools were a demographic questionnaire, general health survey short form (SF36), and Orem cognition form and self-care checklist. Self-care model were held as four 30-45 minutes training sessions based on self-care deficit needs for the experimental group. The quality of life scores was measured in two stages, before and three months after intervention then were compared in both groups. Data were analyzed with statistical software SPSS and use of descriptive analysis tests, Chi-square, Mann-Whitney u and Wilcoxon. The final analysis was performed on 43 experimental and 40 controls. No significant difference was detected in the two groups in terms of demographic variables (P>0.05). All dimensions of quality of life including physical functioning, physical role limitation, body pain, general health, vitality, social functioning and emotional role limitation and mental health in the experimental group showed a significant increase after intervention compared to the control group (Pcare nursing model improves function and overall quality of life and reduces the high cost of a migraine and migraine-related disability to individuals and society.

  5. Efficiency of a Care Coordination Model: A Randomized Study with Stroke Patients

    Science.gov (United States)

    Claiborne, Nancy

    2006-01-01

    Objectives: This study investigated the efficiency of a social work care coordination model for stroke patients. Care coordination addresses patient care and treatment resources across the health care system to reduce risk, improve clinical outcomes, and maximize efficiency. Method: A randomly assigned, pre-post experimental design measured…

  6. Risk prediction models for mortality in patients with ventilator-associated pneumonia

    DEFF Research Database (Denmark)

    Larsson, Johan Erik; Itenov, Theis Skovsgaard; Bestle, Morten Heiberg

    2016-01-01

    PURPOSE: Ventilator-associated pneumonia (VAP) is a common and serious complication in patients requiring mechanical ventilation in the intensive care unit. The aims of this study were to identify models used to predict mortality in VAP patients and to assess their prognostic accuracy. METHODS...

  7. Development and validation of a prognostic model for recurrent glioblastoma patients treated with bevacizumab and irinotecan

    DEFF Research Database (Denmark)

    Urup, Thomas; Dahlrot, Rikke Hedegaard; Grunnet, Kirsten

    2016-01-01

    BACKGROUND: Predictive markers and prognostic models are required in order to individualize treatment of recurrent glioblastoma (GBM) patients. Here, we sought to identify clinical factors able to predict response and survival in recurrent GBM patients treated with bevacizumab (BEV) and irinotecan...

  8. Understanding Dying Patients and Their Families: Using the family FIRO model.

    Science.gov (United States)

    Librach, S L; Talbot, Y

    1991-02-01

    Caring for dying patients and their families presents unique opportunities and challenges for the family physician. The family FIRO model provides a simple way of assessing families and providing appropriate, individualized care. This article outlines the model, discusses the care of dying patients and their families from the FIRO perspective, and provides a guideline for the family physician. A framework is suggested for teaching residents to support families.

  9. A new model to estimate prognosis in patients with hepatocellular carcinoma after Yttrium-90 radioembolization.

    Directory of Open Access Journals (Sweden)

    Zhihong Weng

    Full Text Available AIMS: The current prognostic model to estimate the survival in hepatocellular carcinoma (HCC patients treated with transarterial hepatic selective internal radiotherapy (SIRT is not fully characterized. The aim of this study was to establish a new scoring model including assessment of both tumor responses and therapy-induced systemic changes in HCC patients to predict survival at an early time point post-SIRT. METHODS AND MATERIALS: Between 2008 and 2012, 149 HCC patients treated with SIRT were included into this study. CT images and biomarkers in blood tested at one month post-SIRT were analyzed and correlated with clinical outcome. Tumor responses were assessed by RECIST 1.1, mRECIST, and Choi criteria. Kaplan-Meier methods were used to estimate survival curves. Cox regression was used in uni- and multivariable survival analyses and in the establishment of a prognostic model. RESULTS: A multivariate proportional hazards model was created based on the tumor response, the number of tumor nodules, the score of the model for end stage liver disease (MELD, and the serum C-reactive protein levels which were independent predictors of survival in HCC patients at one month post-SIRT. This prognostic model accurately differentiated the outcome of patients with different risk scores in this cohort (P<0.001. The model also had the ability to assign a predicted survival probability for individual patients. CONCLUSIONS: A new model to predict survival of HCC patients mainly based on tumor responses and therapy-induced systemic changes provides reliable prognosis and accurately discriminates the survival at an early time point after SIRT in these patients.

  10. [Applying Neuman's Systems Model to a neuroleptic malignant syndrome psychiatric patient and his caregiver].

    Science.gov (United States)

    Wang, Shu-Mi; Lai, Chien-Yu

    2010-04-01

    This article describes a nurse's experience using Neuman's Systems Model to care for a chronic psychiatric patient and his caregiver. The patient was diagnosed as suffering from neuroleptic malignant syndrome (NMS). Nursing care described in this article was administered from October 23 to December 4, 2007. The patient developed NMS in the third month of a three-month period of hospitalization, which endangered his life as well as the health of his caregiver. Nursing care was provided to the patient and his caregiver based on Neuman's Systems Model, which included assessments of intrapersonal, interpersonal, and extra-personal forces as well as of environmental factors affecting the health of the patient and his caregiver. The four nursing care issues identified included: existing self-care deficit, sensory/perceptual alteration, sleep pattern disturbance, and caregiver role strain. Following Neuman's systems model, primary, secondary, and tertiary prevention were used to strengthen the flexible lines of defense, internal lines of resistance, and supporting existing strengths of both patient and caregiver, as well as to conserve client system energy. Significant improvements in patient and caregiver abilities were apparent in nursing intervention outcomes. This experience shows the Neuman's systems model to be an efficient model in psychiatric nursing care.

  11. Training to Increase Safe Tray Carrying among Cocktail Servers

    Science.gov (United States)

    Scherrer, Megan D.; Wilder, David A.

    2008-01-01

    We evaluated the effects of training on proper carrying techniques among 3 cocktail servers to increase safe tray carrying on the job and reduce participants' risk of developing musculoskeletal disorders. As participants delivered drinks to their tables, their finger, arm, and neck positions were observed and recorded. Each participant received…

  12. 46 CFR 185.340 - Vessels carrying vehicles.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Vessels carrying vehicles. 185.340 Section 185.340... TONS) OPERATIONS Miscellaneous Operating Requirements § 185.340 Vessels carrying vehicles. (a) Automobiles or other vehicles must be stowed in such a manner as to permit both passengers and crew to get...

  13. 46 CFR 122.340 - Vessels carrying vehicles.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Vessels carrying vehicles. 122.340 Section 122.340... Miscellaneous Operating Requirements § 122.340 Vessels carrying vehicles. (a) Automobiles or other vehicles must... vehicles freely in the event of fire or other disaster. The decks, where necessary, must be...

  14. 25 CFR 11.444 - Carrying concealed weapons.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Carrying concealed weapons. 11.444 Section 11.444 Indians... ORDER CODE Criminal Offenses § 11.444 Carrying concealed weapons. A person who goes about in public places armed with a dangerous weapon concealed upon his or her person is guilty of a misdemeanor unless...

  15. The Disillusion of American Dream in Sister Carrie

    Institute of Scientific and Technical Information of China (English)

    张晴

    2016-01-01

    Dreiser is a generally acknowledged writer as one of American's literary naturalists. In Sister Carrie, the author skillfully used the naturalistic writing style which incisively and vividly showed the society environment at that time. The paper states the process that how the American dream in Sister Carrie disillusioned gradually.

  16. Impact of Patient Empathy Modeling on Pharmacy Students Caring for the Underserved

    Science.gov (United States)

    Chen, Judy T.; LaLopa, Joseph

    2008-01-01

    Objective To determine the impact of the Patient Empathy Modeling pedagogy on students' empathy towards caring for the underserved during an advanced pharmacy practice experience (APPE). Design Pharmacy students completing an APPE at 2 primary care clinics participated in a Patient Empathy Modeling assignment for 10 days. Each student “became the patient,” simulating the life of an actual patient with multiple chronic diseases who was coping with an economic, cultural, or communication barrier to optimal healthcare. Students completed the Jefferson Scale of Physician Empathy (JSPE) before and after completing the assignment, and wrote daily journal entries and a reflection paper. Assessment Twenty-six students completed the PEM exercises from 2005-2006. Scores on the JSPE improved. Students' comments in journals and reflection papers revealed 3 major themes: greater appreciation of the difficulty patients have with adherence to medication and treatment regimens, increased empathy for patients from different backgrounds and patients with medical and psychosocial challenges, and improved ability to apply the lessons learned in the course to their patient care roles. Conclusion A Patient Empathy Modeling assignment improved pharmacy students' empathy toward underserved populations. Integrating the assignment within an APPE allowed students to immediately begin applying the knowledge and insight gained from the exercise. PMID:18483606

  17. Prediction Model of Drug-Induced Liver Injury in Patients with Pulmonary Tuberculosis: Evaluation of the Incidence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Farzaneh Dastan

    2017-03-01

    Full Text Available Introduction and objectives:Tuberculosis (TB still remains a major health concern both in developing and developed countries. The rate of the liver injury due to anti-TB drugs in developed countries has been reported up to 4%. The goal of this study is to assess the rate and risk factors for anti-tuberculosis drug-induced liver injury (DILI. Also, a model has been designed to predict DILI in patients with pulmonary tuberculosis.Methods:We conducted an observational study. The investigation was carried out in the National Research Institute of Tuberculosis and Lung Disease, Tehran, Iran. Anti-tuberculosis drug treatment course and patients’ demographic data, medical and drug history, and social habits were extracted from their medical records. DILI was defined as an increase in serum alanine aminotransfrase (ALT or aspartate aminotransfrase (AST greater than three times of the upper limit of normal (ULN, with symptoms of liver injury, or five times of the ULN without symptoms.Results:In this study, 87 patients (33 male, 54 female, mean age 54.29±21.79 years with tuberculosis diagnosis were followed. Anti-tuberculosis induced liver injury was detected in 14 (16.1% patients. Concomitant use of hepatotoxic drugs (Isoniazid, Rifampin and Pyrazinamide and the abnormal baseline serum liver enzyme levels before the initiation of therapy were found as risk factors for anti-tuberculosis induced liver injury.Conclusion:Anti-tuberculosis induced liver injury is a major problem in tuberculosis patients which lead to treatment interruption in 14 (16.1% patients. Due to the lack of evidence regarding the mechanism of this side effect, we recommend to monitor anti-tuberculosis drug levels in order to study their probable correlations with DILI.   

  18. Research on Carrying Capacity of Water Resource Based on Multi-reservoir Regulation

    Directory of Open Access Journals (Sweden)

    Liu Renyuan

    2013-12-01

    Full Text Available Analyze the level of Carrying Capacity of Water Resources; evaluate the condition of e region social, economic and ecological environment comprehensive and sustainable development. This study is based on analyzing the meaning of water resources carrying capacity, take water resources of the Midwest of Shenzhen City an example., by the way of the “Coordinated and sustainable development” theory, found the model of the Carrying Capacity of Water Resources, Calculated and analyzed. Water efficiency coefficients are different in different states, the Carrying Capacity of Water Resources is different too. the water resources in the Midwest of Shenzhen City can only meet now this stage (2010 Urban water demand, meanwhile people of over loading in there are also constantly increasing, In the future, Water requirement of Shenzhen Midwest cities must increase Dongjiang water and west diversion works of Shen Zhen, in order to enhance Carrying Capacity of Water Resources of the area.

  19. Validation of a Predictive Model to Identify Patients at High Risk for Hospital Readmission.

    Science.gov (United States)

    Spiva, LeeAnna; Hand, Marti; VanBrackle, Lewis; McVay, Frank

    2016-01-01

    Hospital readmission is an adverse patient outcome that is serious, common, and costly. For hospitals, identifying patients at risk for hospital readmission is a priority to reduce costs and improve care. The purposes were to validate a predictive algorithm to identify patients at a high risk for preventable hospital readmission within 30 days after discharge and determine if additional risk factors enhance readmission predictability. A retrospective study was conducted on a randomized sample of 598 patients discharged from a Southeast community hospital. Data were collected from the organization's database and manually abstracted from the electronic medical record using a structured tool. Two separate logistic regression models were fit for the probability of readmission within 30 days after discharge. The first model used the LACE index as the predictor variable, and the second model used the LACE index with additional risk factors. The two models were compared to determine if additional risk factors increased the model's predictive ability. The results indicate both models have reasonable prognostic capability. The LACE index with additional risk factors did little to improve prognostication, while adding to the model's complexity. Findings support the use of the LACE index as a practical tool to identify patients at risk for readmission.

  20. Patient Similarity in Prediction Models Based on Health Data: A Scoping Review

    Science.gov (United States)

    Sharafoddini, Anis; Dubin, Joel A

    2017-01-01

    Background Physicians and health policy makers are required to make predictions during their decision making in various medical problems. Many advances have been made in predictive modeling toward outcome prediction, but these innovations target an average patient and are insufficiently adjustable for individual patients. One developing idea in this field is individualized predictive analytics based on patient similarity. The goal of this approach is to identify patients who are similar to an index patient and derive insights from the records of similar patients to provide personalized predictions.. Objective The aim is to summarize and review published studies describing computer-based approaches for predicting patients’ future health status based on health data and patient similarity, identify gaps, and provide a starting point for related future research. Methods The method involved (1) conducting the review by performing automated searches in Scopus, PubMed, and ISI Web of Science, selecting relevant studies by first screening titles and abstracts then analyzing full-texts, and (2) documenting by extracting publication details and information on context, predictors, missing data, modeling algorithm, outcome, and evaluation methods into a matrix table, synthesizing data, and reporting results. Results After duplicate removal, 1339 articles were screened in abstracts and titles and 67 were selected for full-text review. In total, 22 articles met the inclusion criteria. Within included articles, hospitals were the main source of data (n=10). Cardiovascular disease (n=7) and diabetes (n=4) were the dominant patient diseases. Most studies (n=18) used neighborhood-based approaches in devising prediction models. Two studies showed that patient similarity-based modeling outperformed population-based predictive methods. Conclusions Interest in patient similarity-based predictive modeling for diagnosis and prognosis has been growing. In addition to raw/coded health

  1. Predicting the efficacy of radiotherapy in individual glioblastoma patients in vivo: a mathematical modeling approach

    Energy Technology Data Exchange (ETDEWEB)

    Rockne, R; Alvord, E C Jr; Swanson, K R [Department of Pathology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 (United States); Rockhill, J K; Kalet, I; Hendrickson, K [Department of Radiation Oncology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 (United States); Mrugala, M; Spence, A M [Department of Neurology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195 (United States); Lai, A; Cloughesy, T, E-mail: krae@uw.ed [Department of Neurology, University of California, 710 Westwood Plaza, Los Angeles, CA 90095 (United States)

    2010-06-21

    Glioblastoma multiforme (GBM) is the most malignant form of primary brain tumors known as gliomas. They proliferate and invade extensively and yield short life expectancies despite aggressive treatment. Response to treatment is usually measured in terms of the survival of groups of patients treated similarly, but this statistical approach misses the subgroups that may have responded to or may have been injured by treatment. Such statistics offer scant reassurance to individual patients who have suffered through these treatments. Furthermore, current imaging-based treatment response metrics in individual patients ignore patient-specific differences in tumor growth kinetics, which have been shown to vary widely across patients even within the same histological diagnosis and, unfortunately, these metrics have shown only minimal success in predicting patient outcome. We consider nine newly diagnosed GBM patients receiving diagnostic biopsy followed by standard-of-care external beam radiation therapy (XRT). We present and apply a patient-specific, biologically based mathematical model for glioma growth that quantifies response to XRT in individual patients in vivo. The mathematical model uses net rates of proliferation and migration of malignant tumor cells to characterize the tumor's growth and invasion along with the linear-quadratic model for the response to radiation therapy. Using only routinely available pre-treatment MRIs to inform the patient-specific bio-mathematical model simulations, we find that radiation response in these patients, quantified by both clinical and model-generated measures, could have been predicted prior to treatment with high accuracy. Specifically, we find that the net proliferation rate is correlated with the radiation response parameter (r = 0.89, p = 0.0007), resulting in a predictive relationship that is tested with a leave-one-out cross-validation technique. This relationship predicts the tumor size post-therapy to within inter

  2. Modeling the MagnetoencephaloGram (MEG) Of Epileptic Patients Using Genetic Programming and Minimizing the Derived Models Using Genetic Algorithms

    Science.gov (United States)

    Theofilatos, Konstantinos; Georgopoulos, Efstratios; Likothanassis, Spiridon

    2009-09-01

    In this paper, a variation of traditional Genetic Programming(GP) is used to model the MagnetoencephaloGram(MEG) of Epileptic Patients. This variation is Linear Genetic Programming(LGP). LGP is a particular subset of GP wherein computer programs in population are represented as a sequence of instructions from imperative programming language or machine language. The derived models from this method were simplified using genetic algorithms. The proposed method was used to model the MEG signal of epileptic patients using 6 different datasets. Each dataset uses different number of previous values of MEG to predict the next value. The models were tested in datasets different from the ones which were used to produce them and the results were very promising.

  3. Estimating landscape carrying capacity through maximum clique analysis.

    Science.gov (United States)

    Donovan, Therese M; Warrington, Gregory S; Schwenk, W Scott; Dinitz, Jeffrey H

    2012-12-01

    Habitat suitability (HS) maps are widely used tools in wildlife science and establish a link between wildlife populations and landscape pattern. Although HS maps spatially depict the distribution of optimal resources for a species, they do not reveal the population size a landscape is capable of supporting--information that is often crucial for decision makers and managers. We used a new approach, "maximum clique analysis," to demonstrate how HS maps for territorial species can be used to estimate the carrying capacity, N(k), of a given landscape. We estimated the N(k) of Ovenbirds (Seiurus aurocapillus) and bobcats (Lynx rufus) in an 1153-km2 study area in Vermont, USA. These two species were selected to highlight different approaches in building an HS map as well as computational challenges that can arise in a maximum clique analysis. We derived 30-m2 HS maps for each species via occupancy modeling (Ovenbird) and by resource utilization modeling (bobcats). For each species, we then identified all pixel locations on the map (points) that had sufficient resources in the surrounding area to maintain a home range (termed a "pseudo-home range"). These locations were converted to a mathematical graph, where any two points were linked if two pseudo-home ranges could exist on the landscape without violating territory boundaries. We used the program Cliquer to find the maximum clique of each graph. The resulting estimates of N(k) = 236 Ovenbirds and N(k) = 42 female bobcats were sensitive to different assumptions and model inputs. Estimates of N(k) via alternative, ad hoc methods were 1.4 to > 30 times greater than the maximum clique estimate, suggesting that the alternative results may be upwardly biased. The maximum clique analysis was computationally intensive but could handle problems with < 1500 total pseudo-home ranges (points). Given present computational constraints, it is best suited for species that occur in clustered distributions (where the problem can be

  4. National attitudes concerning gun carrying in the United States.

    Science.gov (United States)

    Hemenway, D; Azrael, D; Miller, M

    2001-12-01

    To determine public attitudes in the United States concerning gun carrying. In the past 15 years, many state legislatures have passed laws making it easier for United States citizens to carry concealed firearms, not only on the street but into various locations, including churches and government buildings. National random digit dial telephone surveys conducted in 1996 and 1999 asked questions concerning the public's feelings of safety as more people in their community carry firearms, and whether, in the language of the question, respondents believe "regular" citizens should be allowed to carry guns into public or government buildings. Americans feel less safe rather than more safe as more people in their community begin to carry guns. By margins of at least nine to one, Americans do not believe that "regular" citizens should be allowed to bring their guns into restaurants, college campuses, sports stadiums, bars, hospitals, or government buildings. The public believes that increased gun carrying by others reduces rather than increases their safety. Overwhelmingly, the public believes that in many venues gun carrying should be prohibited.

  5. Multivariable Model for Time to First Treatment in Patients With Chronic Lymphocytic Leukemia

    Science.gov (United States)

    Wierda, William G.; O'Brien, Susan; Wang, Xuemei; Faderl, Stefan; Ferrajoli, Alessandra; Do, Kim-Anh; Garcia-Manero, Guillermo; Cortes, Jorge; Thomas, Deborah; Koller, Charles A.; Burger, Jan A.; Lerner, Susan; Schlette, Ellen; Abruzzo, Lynne; Kantarjian, Hagop M.; Keating, Michael J.

    2011-01-01

    Purpose The clinical course for patients with chronic lymphocytic leukemia (CLL) is diverse; some patients have indolent disease, never needing treatment, whereas others have aggressive disease requiring early treatment. We continue to use criteria for active disease to initiate therapy. Multivariable analysis was performed to identify prognostic factors independently associated with time to first treatment for patients with CLL. Patients and Methods Traditional laboratory, clinical prognostic, and newer prognostic factors such as fluorescent in situ hybridization (FISH), IGHV mutation status, and ZAP-70 expression evaluated at first patient visit to MD Anderson Cancer Center were correlated by multivariable analysis with time to first treatment. This multivariable model was used to develop a nomogram—a weighted tool to calculate 2- and 4-year probability of treatment and estimate median time to first treatment. Results There were 930 previously untreated patients who had traditional and new prognostic factors evaluated; they did not have active CLL requiring initiation of treatment within 3 months of first visit and were observed for time to first treatment. The following were independently associated with shorter time to first treatment: three involved lymph node sites, increased size of cervical lymph nodes, presence of 17p deletion or 11q deletion by FISH, increased serum lactate dehydrogenase, and unmutated IGHV mutation status. Conclusion We developed a multivariable model that incorporates traditional and newer prognostic factors to identify patients at high risk for progression to treatment. This model may be useful to identify patients for early interventional trials. PMID:21969505

  6. Social networks enabled coordination model for cost management of patient hospital admissions.

    Science.gov (United States)

    Uddin, Mohammed Shahadat; Hossain, Liaquat

    2011-09-01

    In this study, we introduce a social networks enabled coordination model for exploring the effect of network position of "patient," "physician," and "hospital" actors in a patient-centered care network that evolves during patient hospitalization period on the total cost of coordination. An actor is a node, which represents an entity such as individual and organization in a social network. In our analysis of actor networks and coordination in the healthcare literature, we identified that there is significant gap where a number of promising hospital coordination model have been developed (e.g., Guided Care Model, Chronic Care Model) for the current healthcare system focusing on quality of service and patient satisfaction. The health insurance dataset for total hip replacement (THR) from hospital contribution fund, a prominent Australian Health Insurance Company, are analyzed to examine our proposed coordination model. We consider network attributes of degree, connectedness, in-degree, out-degree, and tie strength to measure network position of actors. To measure the cost of coordination for a particular hospital, average of total hospitalization expenses for all THR hospital admissions is used. Results show that network positions of "patient," "physician," and "hospital" actors considering all hospital admissions that a particular hospital has have effect on the average of total hospitalization expenses of that hospital. These results can be used as guidelines to set up a cost-effective healthcare practice structure for patient hospitalization expenses.

  7. Model Construction for the Intention to Use Telecare in Patients with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Jui-Chen Huang

    2013-01-01

    Full Text Available Objective. This study chose patients with chronic diseases as study subjects to investigate their intention to use telecare. Methods. A large medical institute in Taiwan was used as the sample unit. Patients older than 20 years, who had chronic diseases, were sampled by convenience sampling and surveyed with a structural questionnaire, and a total of 500 valid questionnaires were collected. Model construction was based on the Health Belief Model. The reliability and validity of the measurement model were tested using confirmatory factor analysis (CFA, and the causal model was explained by structural equation modeling (SEM. Results. The priority should be on promoting the perceived benefits of telecare, with a secondary focus on the external cues to action, such as promoting the influences of important people on the patients. Conclusion. The findings demonstrated that patients with chronic diseases use telecare differently from the general public. To promote the use and acceptance of telecare in patients with chronic diseases, technology developers should prioritize the promotion of the usefulness of telecare. In addition, policy makers can strengthen the marketing from media and medical personnel, in order to increase the acceptance of telecare by patients with chronic diseases.

  8. Prediction using patient comparison vs. modeling: a case study for mortality prediction.

    Science.gov (United States)

    Hoogendoorn, Mark; El Hassouni, Ali; Mok, Kwongyen; Ghassemi, Marzyeh; Szolovits, Peter

    2016-08-01

    Information in Electronic Medical Records (EMRs) can be used to generate accurate predictions for the occurrence of a variety of health states, which can contribute to more pro-active interventions. The very nature of EMRs does make the application of off-the-shelf machine learning techniques difficult. In this paper, we study two approaches to making predictions that have hardly been compared in the past: (1) extracting high-level (temporal) features from EMRs and building a predictive model, and (2) defining a patient similarity metric and predicting based on the outcome observed for similar patients. We analyze and compare both approaches on the MIMIC-II ICU dataset to predict patient mortality and find that the patient similarity approach does not scale well and results in a less accurate model (AUC of 0.68) compared to the modeling approach (0.84). We also show that mortality can be predicted within a median of 72 hours.

  9. Shared care is a model for patients with stable prostate cancer

    DEFF Research Database (Denmark)

    Lund, Lars; Jønler, Morten; Graversen, Hans Peder

    2013-01-01

    general practitioners (GPs) can handle follow-up. MATERIAL AND METHODS: A Steering Committee was established in collaboration with health-care professionals to devise a strategy for a shared care model. An action plan was designed that included 1) the development of a shared care model for follow......-up and treatment, 2) implementation of the shared care model in cooperation between the parties involved, 3) design of procedures for re-referral, and 4) evaluation of effect, change processes and contextual factors. RESULTS: A total of 2,585 patients with PC were included in the study: 1,172 had disseminated...... to follow-up with a GP and 2,055 were not transferred to their GP. The main reason why patients were considered not suitable for transfer to primary health care was the patients' own desire (33%), followed by clinical or biochemical disease progression (33%). The evaluation found that 96% of the patients...

  10. Combined Population Dynamics and Entropy Modelling Supports Patient Stratification in Chronic Myeloid Leukemia

    Science.gov (United States)

    Brehme, Marc; Koschmieder, Steffen; Montazeri, Maryam; Copland, Mhairi; Oehler, Vivian G.; Radich, Jerald P.; Brümmendorf, Tim H.; Schuppert, Andreas

    2016-04-01

    Modelling the parameters of multistep carcinogenesis is key for a better understanding of cancer progression, biomarker identification and the design of individualized therapies. Using chronic myeloid leukemia (CML) as a paradigm for hierarchical disease evolution we show that combined population dynamic modelling and CML patient biopsy genomic analysis enables patient stratification at unprecedented resolution. Linking CD34+ similarity as a disease progression marker to patient-derived gene expression entropy separated established CML progression stages and uncovered additional heterogeneity within disease stages. Importantly, our patient data informed model enables quantitative approximation of individual patients’ disease history within chronic phase (CP) and significantly separates “early” from “late” CP. Our findings provide a novel rationale for personalized and genome-informed disease progression risk assessment that is independent and complementary to conventional measures of CML disease burden and prognosis.

  11. Patient-Derived Xenograft Models : An Emerging Platform for Translational Cancer Research

    NARCIS (Netherlands)

    Hidalgo, Manuel; Amant, Frederic; Biankin, Andrew V.; Budinska, Eva; Byrne, Annette T.; Caldas, Carlos; Clarke, Robert B.; de Jong, Steven; Jonkers, Jos; Maelandsmo, Gunhild Mari; Roman-Roman, Sergio; Seoane, Joan; Trusolino, Livio; Villanueva, Alberto

    2014-01-01

    Recently, there has been an increasing interest in the development and characterization of patient-derived tumor xenograft (PDX) models for cancer research. PDX models mostly retain the principal histologic and genetic characteristics of their donor tumor and remain stable across passages. These mod

  12. Method for evaluating prediction models that apply the results of randomized trials to individual patients

    Directory of Open Access Journals (Sweden)

    Kattan Michael W

    2007-06-01

    Full Text Available Abstract Introduction The clinical significance of a treatment effect demonstrated in a randomized trial is typically assessed by reference to differences in event rates at the group level. An alternative is to make individualized predictions for each patient based on a prediction model. This approach is growing in popularity, particularly for cancer. Despite its intuitive advantages, it remains plausible that some prediction models may do more harm than good. Here we present a novel method for determining whether predictions from a model should be used to apply the results of a randomized trial to individual patients, as opposed to using group level results. Methods We propose applying the prediction model to a data set from a randomized trial and examining the results of patients for whom the treatment arm recommended by a prediction model is congruent with allocation. These results are compared with the strategy of treating all patients through use of a net benefit function that incorporates both the number of patients treated and the outcome. We examined models developed using data sets regarding adjuvant chemotherapy for colorectal cancer and Dutasteride for benign prostatic hypertrophy. Results For adjuvant chemotherapy, we found that patients who would opt for chemotherapy even for small risk reductions, and, conversely, those who would require a very large risk reduction, would on average be harmed by using a prediction model; those with intermediate preferences would on average benefit by allowing such information to help their decision making. Use of prediction could, at worst, lead to the equivalent of an additional death or recurrence per 143 patients; at best it could lead to the equivalent of a reduction in the number of treatments of 25% without an increase in event rates. In the Dutasteride case, where the average benefit of treatment is more modest, there is a small benefit of prediction modelling, equivalent to a reduction of

  13. An Alternative Approach for High Speed Railway Carrying Capacity Calculation Based on Multiagent Simulation

    Directory of Open Access Journals (Sweden)

    Mo Gao

    2016-01-01

    Full Text Available It is a multiobjective mixed integer programming problem that calculates the carrying capacity of high speed railway based on mathematical programming method. The model is complex and difficult to solve, and it is difficult to comprehensively consider the various influencing factors on the train operation. The multiagent theory is employed to calculate high speed railway carrying capacity. In accordance with real operations of high speed railway, a three-layer agent model is developed to simulate the operating process of high speed railway. In the proposed model, railway network agent, line agent, station agent, and train agent are designed, respectively. To validate the proposed model, a case study is performed for Beijing–Shanghai high speed railway by using NetLogo software. The results are consistent with the actual data, which implies that the proposed multiagent method is feasible to calculate the carrying capacity of high speed railway.

  14. Building prognostic models for breast cancer patients using clinical variables and hundreds of gene expression signatures

    Directory of Open Access Journals (Sweden)

    Liu Yufeng

    2011-01-01

    Full Text Available Abstract Background Multiple breast cancer gene expression profiles have been developed that appear to provide similar abilities to predict outcome and may outperform clinical-pathologic criteria; however, the extent to which seemingly disparate profiles provide additive prognostic information is not known, nor do we know whether prognostic profiles perform equally across clinically defined breast cancer subtypes. We evaluated whether combining the prognostic powers of standard breast cancer clinical variables with a large set of gene expression signatures could improve on our ability to predict patient outcomes. Methods Using clinical-pathological variables and a collection of 323 gene expression "modules", including 115 previously published signatures, we build multivariate Cox proportional hazards models using a dataset of 550 node-negative systemically untreated breast cancer patients. Models predictive of pathological complete response (pCR to neoadjuvant chemotherapy were also built using this approach. Results We identified statistically significant prognostic models for relapse-free survival (RFS at 7 years for the entire population, and for the subgroups of patients with ER-positive, or Luminal tumors. Furthermore, we found that combined models that included both clinical and genomic parameters improved prognostication compared with models with either clinical or genomic variables alone. Finally, we were able to build statistically significant combined models for pathological complete response (pCR predictions for the entire population. Conclusions Integration of gene expression signatures and clinical-pathological factors is an improved method over either variable type alone. Highly prognostic models could be created when using all patients, and for the subset of patients with lymph node-negative and ER-positive breast cancers. Other variables beyond gene expression and clinical-pathological variables, like gene mutation status or DNA

  15. Focused interventional cancer radiation therapy using lipid nanoparticle-carried radionuclides

    Science.gov (United States)

    Hrycushko, Brian Andrew

    2011-07-01

    The overall goal in cancer therapy is to achieve complete tumor eradication while causing minimal damage to healthy organs and tissue. Based on the broadly accepted theory of tumor control being a probabilistic event, every fraction of radiation treatment kills a portion of cancer cells and higher radiation dose should result in improved tumor control. Ultimately, radiation oncologists must balance the delivery of high enough radiation to tumors for achieving tumor control while not delivering so much radiation as to cause unacceptable normal tissue risk. This project centers on the locoregional delivery of lipid (liposome) nanoparticle-carried therapeutic radionuclides (186Re/ 188Re) to apply a focal and ablative radiation dose to target regions while greatly decreasing normal tissue toxicity of surrounding tissues. Specific Aim 1 includes the development of dosimetric and radiobiological models to assess small animal / patient specific radionuclide therapy at a voxel level. This will be used for a proof of concept study to characterize a novel technique to treat the post-lumpectomy wall for residual early stage breast cancer while simultaneously treating draining lymph nodes. Specific Aim 2 will look at methods of improving therapeutic ratio by evaluating in vivo characteristics of different liposome formulations and tumor vasculature modification chemicals following direct intratumoral infusion of 99m Tc-liposomes within a human head and neck squamous cell carcinoma xenograft (HNSCC) model in nude rats. Specific Aim 3 will evaluate the therapy potential for direct intratumoral injection of 186Re-liposomes within a human HNSCC xenograft model in nude rats using the dosimetric and radiobiological models of Aim 1 with improved treatment modifications from Aim 2.

  16. An inpatient rehabilitation model of care targeting patients with cognitive impairment

    Directory of Open Access Journals (Sweden)

    McGilton Katherine S

    2012-05-01

    Full Text Available Abstract Background The course and outcomes of hip fracture patients are often complicated by the presence of dementia and delirium, referred to as cognitive impairment (CI, which limits access to in-patient rehabilitation. In response to this concern, members of our team developed and piloted an in-patient rehabilitation model of care (Patient-Centred Rehabilitation Model; PCRM targeting patients with hip fracture and CI (PCRM-CI. We are now conducting a 3-year study comparing an inpatient rehabilitation model of care for community dwelling individuals with hip fracture and CI (PCRM-CI to usual care to determine whether it results in improved mobility at the time of discharge from inpatient rehabilitation. Methods/Design A non-equivalent pre-post design is being used to evaluate the PCRM-CI compared to usual care. All community dwelling (private home or retirement home patients following a hip fracture are eligible to participate. Recruitment of both cohorts is taking place at two facilities. Target accrual is 70 hip fracture patients in the PCRM-CI cohort and 70 patients in the usual care cohort. We are also recruiting 70 health care providers (HCPs, who are being trained to implement the PCRM-CI, and their unit managers. Patient data are collected at baseline, discharge, and 6 months post-discharge from an inpatient rehabilitation program. Evaluations include mobility, physical function, and living arrangement. Additional outcome variables are being collected from medical records and from the patients via their proxies. Data on the prevalence and severity of dementia and delirium are being collected. Staff data are collected at baseline and one year after implementation of the model to determine change in staff knowledge and attitudes toward patients with hip fracture and CI. Bi-monthly semi-structured interviews with unit managers have been conducted to examine factors and barriers influencing the model implementation. Data collection

  17. Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models.

    Science.gov (United States)

    Xie, Tianwu; Poletti, Pierre-Alexandre; Platon, Alexandra; Becker, Christoph D; Zaidi, Habib

    2017-09-08

    This work provides detailed estimates of the foetal dose from diagnostic CT imaging of pregnant patients to enable the assessment of the diagnostic benefits considering the associated radiation risks. To produce realistic biological and physical representations of pregnant patients and the embedded foetus, we developed a methodology for construction of patient-specific voxel-based computational phantoms based on existing standardised hybrid computational pregnant female phantoms. We estimated the maternal absorbed dose and foetal organ dose for 30 pregnant patients referred to the emergency unit of Geneva University Hospital for abdominal CT scans. The effective dose to the mother varied from 1.1 mSv to 2.0 mSv with an average of 1.6 mSv, while commercial dose-tracking software reported an average effective dose of 1.9 mSv (range 1.7-2.3 mSv). The foetal dose normalised to CTDIvol varies between 0.85 and 1.63 with an average of 1.17. The methodology for construction of personalised computational models can be exploited to estimate the patient-specific radiation dose from CT imaging procedures. Likewise, the dosimetric data can be used for assessment of the radiation risks to pregnant patients and the foetus from various CT scanning protocols, thus guiding the decision-making process. • In CT examinations, the absorbed dose is non-uniformly distributed within foetal organs. • This work reports, for the first time, estimates of foetal organ-level dose. • The foetal brain and skeleton doses present significant correlation with gestational age. • The conceptus dose normalised to CTDI vol varies between 0.85 and 1.63. • The developed methodology is adequate for patient-specific CT radiation dosimetry.

  18. Assessing overall patient satisfaction in inflammatory bowel disease using structural equation modeling.

    Science.gov (United States)

    Soares, João-Bruno; Marinho, Ana S; Fernandes, Dália; Moreira Gonçalves, Bruno; Camila-Dias, Cláudia; Gonçalves, Raquel; Magro, Fernando

    2015-08-01

    Structural equation modeling (SEM) is a very popular data-analytic technique for the evaluation of customer satisfaction. We aimed to measure the overall satisfaction of inflammatory bowel disease (IBD) patients with healthcare in Portugal and to define its main determinants using SEM. The study included three steps: (i) specification of a patient satisfaction model that included the following dimensions: Image, Expectations, Facilities, Admission process, Assistant staff, Nursing staff, Medical staff, Treatment, Inpatient care, Outpatient care, Overall quality, Overall satisfaction, and Loyalty; (ii) sample survey from 2000 patients, members of the Portuguese Association of the IBD; and (iii) estimation of the satisfaction model using partial least squares (XLSTAT-PLSPM). We received 498 (25%) valid questionnaires from 324 (66%) patients with Crohn's disease and 162 (33%) patients with ulcerative colitis. Our model provided a substantial explanation for Overall satisfaction (R=0.82). The mean index of overall satisfaction was 74.4 (0-100 scale). The main determinants of Overall satisfaction were the Image (β=0.26), Outpatient care (β=0.23), and Overall quality (β=0.21), whose mean indices were 83, 75, and 81, respectively. Facilities and Inpatient care were the variables with a significant impact on Overall satisfaction and the worst mean indices. SEM is useful for the evaluation of IBD patient satisfaction. The Overall satisfaction of IBD patients with healthcare in Portugal is good, but to increase it, IBD services need to focus on the improvement of Outpatient care, Facilities, and Inpatient care. Our model could be a matrix for a global model of IBD patient satisfaction.

  19. Classification and regression tree (CART model to predict pulmonary tuberculosis in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Aguiar Fabio S

    2012-08-01

    Full Text Available Abstract Background Tuberculosis (TB remains a public health issue worldwide. The lack of specific clinical symptoms to diagnose TB makes the correct decision to admit patients to respiratory isolation a difficult task for the clinician. Isolation of patients without the disease is common and increases health costs. Decision models for the diagnosis of TB in patients attending hospitals can increase the quality of care and decrease costs, without the risk of hospital transmission. We present a predictive model for predicting pulmonary TB in hospitalized patients in a high prevalence area in order to contribute to a more rational use of isolation rooms without increasing the risk of transmission. Methods Cross sectional study of patients admitted to CFFH from March 2003 to December 2004. A classification and regression tree (CART model was generated and validated. The area under the ROC curve (AUC, sensitivity, specificity, positive and negative predictive values were used to evaluate the performance of model. Validation of the model was performed with a different sample of patients admitted to the same hospital from January to December 2005. Results We studied 290 patients admitted with clinical suspicion of TB. Diagnosis was confirmed in 26.5% of them. Pulmonary TB was present in 83.7% of the patients with TB (62.3% with positive sputum smear and HIV/AIDS was present in 56.9% of patients. The validated CART model showed sensitivity, specificity, positive predictive value and negative predictive value of 60.00%, 76.16%, 33.33%, and 90.55%, respectively. The AUC was 79.70%. Conclusions The CART model developed for these hospitalized patients with clinical suspicion of TB had fair to good predictive performance for pulmonary TB. The most important variable for prediction of TB diagnosis was chest radiograph results. Prospective validation is still necessary, but our model offer an alternative for decision making in whether to isolate patients with

  20. Comparison of models for predicting outcomes in patients with coronary artery disease focusing on microsimulation

    Directory of Open Access Journals (Sweden)

    Masoud Amiri

    2012-01-01

    Full Text Available Background: Physicians have difficulty to subjectively estimate the cardiovascular risk of their patients. Using an estimate of global cardiovascular risk could be more relevant to guide decisions than using binary representation (presence or absence of risk factors data. The main aim of the paper is to compare different models of predicting the progress of a coronary artery diseases (CAD to help the decision making of physician. Methods: There are different standard models for predicting risk factors such as models based on logistic regression model, Cox regression model, dynamic logistic regression model, and simulation models such as Markov model and microsimulation model. Each model has its own application which can or cannot use by physicians to make a decision on treatment of each patient. Results: There are five main common models for predicting of outcomes, including models based on logistic regression model (for short-term outcomes, Cox regression model (for intermediate-term outcomes, dynamic logistic regression model, and simulation models such as Markov and microsimulation models (for long-term outcomes. The advantages and disadvantages of these models have been discussed and summarized. Conclusion: Given the complex medical decisions that physicians face in everyday practice, the multiple interrelated factors that play a role in choosing the optimal treatment, and the continuously accumulating new evidence on determinants of outcome and treatment options for CAD, physicians may potentially benefit from a clinical decision support system that accounts for all these considerations. The microsimulation model could provide cardiologists, researchers, and medical students a user-friendly software, which can be used as an intelligent interventional simulator.

  1. Test-retest reliability of lifting and carrying in a 2-day functional capacity evaluation.

    Science.gov (United States)

    Reneman, M F; Dijkstra, P U; Westmaas, M; Göeken, L N H

    2002-12-01

    The objectives of this study were to establish test-retest reliability of lifting and carrying of a functional capacity evaluation (FCE) on two consecutive days and to verify the need for a 2-day protocol. A cohort of 50 patients (39 men, 11 women) with nonspecific low back pain were evaluated using a 2-day FCE protocol. Intraclass correlation coefficients (ICC) were calculated for weight lifted and carried. Predictive relationships between test and retest were explored by means of a regression analysis. The results of ICC were lifting low 0.87, lifting overhead 0.87, and carrying 0.77. Performances on day 2 were on an average 6-9% higher. Other than the amount of weight handled on day 1, no variable was found to predict performance on day 2. It was concluded that test-retest reliability of lifting and carrying was good, and the need for a 2-day protocol could not be confirmed.

  2. Individuality of breathing patterns in patients under noninvasive mechanical ventilation evidenced by chaotic global models

    Science.gov (United States)

    Letellier, Christophe; Rodrigues, Giovani G.; Muir, Jean-François; Aguirre, Luis A.

    2013-03-01

    Autonomous global models based on radial basis functions were obtained from data measured from patients under noninvasive mechanical ventilation. Some of these models, which are discussed in the paper, turn out to have chaotic or quasi-periodic solutions, thus providing a first piece of evidence that the underlying dynamics of the data used to estimate the global models are likely to be chaotic or, at least, have a chaotic component. It is explicitly shown that one of such global models produces attractors characterized by a Horseshoe map, two models produce toroidal chaos, and one model produces a quasi-periodic regime. These topologically inequivalent attractors evidence the individuality of breathing profiles observed in patient under noninvasive ventilation.

  3. Relevance of pharmacokinetic and pharmacodynamic modeling to clinical care of critically ill patients.

    Science.gov (United States)

    Bulitta, Jurgen B; Landersdorfer, Cornelia B; Forrest, Alan; Brown, Silvia V; Neely, Michael N; Tsuji, Brian T; Louie, Arnold

    2011-12-01

    Efficacious therapy is of utmost importance to save lives and prevent bacterial resistance in critically ill patients. This review summarizes pharmacokinetic (PK) and pharmacodynamic (PD) modeling methods to optimize clinical care of critically ill patients in empiric and individualized therapy. While these methods apply to all therapeutic areas, we focus on antibiotics to highlight important applications, as emergence of resistance is a significant problem. Nonparametric and parametric population PK modeling, multiple-model dosage design, Monte Carlo simulations, and Bayesian adaptive feedback control are the methods of choice to optimize therapy. Population PK can estimate between patient variability and account for potentially increased clearances and large volumes of distribution in critically ill patients. Once patient- specific PK data become available, target concentration intervention and adaptive feedback control algorithms can most precisely achieve target goals such as clinical cure of an infection or resistance prevention in stable and unstable patients with rapidly changing PK parameters. Many bacterial resistance mechanisms cause PK/PD targets for resistance prevention to be usually several-fold higher than targets for near-maximal killing. In vitro infection models such as the hollow fiber and one-compartment infection models allow one to study antibiotic-induced bacterial killing and emergence of resistance of mono- and combination therapies over clinically relevant treatment durations. Mechanism-based (and empirical) PK/PD modeling can incorporate effects of the immune system and allow one to design innovative dosage regimens and prospective validation studies. Mechanism-based modeling holds great promise to optimize mono- and combination therapy of anti-infectives and drugs from other therapeutic areas for critically ill patients.

  4. Estimating the recreational carrying capacity of a lowland river section.

    Science.gov (United States)

    Lorenz, Stefan; Pusch, Martin T

    2012-01-01

    Recreational boating represents a major human use of inland waters in many regions. However, boating tourism may affect the ecological integrity of surface waters in multiple ways. In particular, surface waves produced by boating may disturb freshwater invertebrates, such as interrupting the filtration activity of benthic mussels. As mussels may significantly contribute to self-purification, disturbance may have crucial impacts on water quality, and thus on water tourism. In this paper we calculate the carrying capacity of a river section for sustainable boating tourism based on the preservation of water quality. This approach is complemented by spatial and social approaches for carrying capacity estimates. The ecological carrying capacity significantly decreases with lower water levels during summer. Hence, the analysis of variables that influence the river's carrying capacity allows the formation of recommendations for management measures that integrate social, touristic and ecological aspects.

  5. Carrying Network Accessing Architecture and Strategy Based on Business Differentiation

    Directory of Open Access Journals (Sweden)

    Yanyan Han

    2013-07-01

    Full Text Available Due to the abilities of real-time sensing and information sharing, Wireless Sensor Network (WSN has been applied in more and more fields. Basing on the emergence of Internet of Things (IoT, the issue about heterogeneous network integration is becoming more important. We first analyze the new businesses that arise recently for cell phone users as well as the potential effect on carrying network. After that we mainly discuss the influence on traditional carrying network for WSN accessing and taking concurrent businesses as the study case, common access architecture from WSN to carrying network is constructed, which makes use of business differentiation. Furthermore, we propose the idea of tortuous access from WSN to the gateway in the carrying network to avoid congested paths with simulation and verification. Finally, we conclude the possible impacts for the integration of these two networks and present possible solutions.

  6. Lane of parallel through carry in ternary optical adder

    Institute of Scientific and Technical Information of China (English)

    JIN Yi; HE Huacan; AI Lirong

    2005-01-01

    At the present 50 to 100 microseconds are necessary for a liquid crystal to change its state from opacity to clarity; 1.14× 10-5 microseconds are however proved to be enough for light to pass through a clarity liquid crystal device. Rooted from this great difference in time, an optical adder was constructed with parallel through carry lanes (PTCL) composed of liquid crystals. Because all carries in PTCL process in parallel, the carry delay in the ternary optical computer's adder is avoided. Eliminating the carry delay in adder of ternary optical computer by physical means, the PTCL is also applicable for other types of optical adders. Moreover a light diagram of the adder and one PTCL structure are provided.

  7. Determination of the sediment carrying capacity based on perturbed theory.

    Science.gov (United States)

    Ni, Zhi-hui; Zeng, Qiang; Li-chun, Wu

    2014-01-01

    According to the previous studies of sediment carrying capacity, a new method of sediment carrying capacity on perturbed theory was proposed. By taking into account the average water depth, average flow velocity, settling velocity, and other influencing factors and introducing the median grain size as one main influencing factor in deriving the new formula, we established a new sediment carrying capacity formula. The coefficients were determined by the principle of dimensional analysis, multiple linear regression method, and the least square method. After that, the new formula was verified through measuring data of natural rivers and flume tests and comparing the verified results calculated by Cao Formula, Zhang Formula, Li Formula, Engelung-Hansen Formula, Ackers-White Formula, and Yang Formula. According to the compared results, it can be seen that the new method is of high accuracy. It could be a useful reference for the determination of sediment carrying capacity.

  8. Measuring the Magnetic Force on a Current-Carrying Conductor.

    Science.gov (United States)

    Herreman, W.; Huysentruyt, R.

    1995-01-01

    Describes a fast and simple method for measuring the magnetic force acting on a current-carrying conductor using a digital balance. Discusses the influence of current intensity and wire length on the magnetic force on the conductor. (JRH)

  9. Exercise effects in a virtual type 1 diabetes patient: Using stochastic differential equations for model extension

    DEFF Research Database (Denmark)

    Duun-Henriksen, Anne Katrine; Schmidt, S.; Nørgaard, K.

    2013-01-01

    The use of virtual patients for in silico testing of control algorithms for an artificial pancreas is growing. It is an easy, fast and low-cost alternative to pre-clinical testing. To simulate the everyday life of a type 1 diabetes (T1D) patient a simulator must be able to take into account...... extension incorporating exercise effects on insulin and glucose dynamics. Our model is constructed as a stochastic state space model consisting of a set of stochastic differential equations (SDEs). In a stochastic state space model, the residual error is split into random measurement error...... on clinical data from a study including exercise bouts of 20 minutes performed on 12 T1D patients treated with continuous subcutaneous insulin infusion. The predictive abilities of the model are investigated. In conclusion, this study illustrates the advantages of using SDEs in the development of an extended...

  10. Using an age-specific nursing model to tailor care to the adolescent surgical patient.

    Science.gov (United States)

    Monahan, Janean Carter

    2014-06-01

    A surgical experience can be stressful for any patient. When the patient is an adolescent, however, the surgical experience can create significant stress, which is related to normal adolescent development. Perioperative nursing care should address what adolescent patients perceive as stressful and should provide a safe environment so that a successful surgical outcome can be achieved. To accomplish this, a nursing model specific to perioperative nursing practice should be developed to guide nurses when providing care to adolescents. The Adolescent Perioperative System Stability Model based on the Neuman Systems Model provides a framework for defining scope of practice and organizing nursing care that is appropriate for the adolescent during a surgical experience. In addition to guiding nursing practice, this model provides direction and guidance for future studies of adolescents in the perioperative setting.

  11. Archetype based patient data modeling to support treatment of pituitary adenomas.

    Science.gov (United States)

    Chalopin, Claire; Lindner, Dirk; Kropf, Stefan; Denecke, Kerstin

    2015-01-01

    The treatment of patients with pituitary adenoma requires the assessment of various patient data by the clinician. Because of their heterogeneity, they are stored in different sub-information systems, limiting a fast and easy access. The objective of this paper is to apply and test the tools provided by the openEHR Foundation to model the patient data relevant for diagnosis and treatment of the disease with the future intention to implement a centralised standard-based information platform. This platform should support the clinician in the treatment of the disease and improve the information exchange with other healthcare institutions. Some results of the domain modeling, so far obtained, are presented, and the advantages of openEHR emphasized. The free tools and the large database of existing structured and standard archetypes facilitated the modeling task. The separation of the domain modeling from the application development will support the next step of development of the information platform.

  12. Comprehensive Measurement for Carrying Capacity of Resources and Environment of City Clusters in Central China

    Institute of Scientific and Technical Information of China (English)

    FANG Chuanglin; LIU Xiaoli

    2010-01-01

    Studying the carrying capacity of resources and environment of city clusters in the central China has impor-tant practical guidance significance for promoting the healthy,sustainable and stable development of this region.Ac-cording to their influencing factors and reciprocity mechanism,using system dynamics approaches,this paper built a SD model for measuring the carrying capacity of resources and environment of the city clusters in the central China,and through setting different development models,the comprehensive measurement analysis on the carrying capacity was carried out.The results show that the model of promoting socio-economic development under the protection of resources and environment is the optimal model for promoting the harmony development of resources,environment,society and economy in the city clusters.According to this model,the optimum population scale of the city clusters in2020 is 42.80×106 persons,and the moderate economic development scale is 22.055× 1012 yuan(RMB).In 1996-2020,the carrying capacity of resources and environment in the city clusters took on obvious phase-change characteristics.During the studied period,it is basically at the initial development stage,and will come through the development process from slow development to speedup development.

  13. 基于辅助阵元的方位依赖幅相误差最大似然自校正:针对确定信号模型%Maximum likelihood self-calibration for direction-dependent gain-phase errors with carry-on instrumental sensors:case of deterministic signal model

    Institute of Scientific and Technical Information of China (English)

    王鼎; 潘苗; 吴瑛

    2011-01-01

    Aim at the self-calibration of direction-dependent gm-phase errors in case of deterministic signal model, the maximum likelihood method(MLM) for calibrating the direction-dependent gain-phase errors with carry-on instrumental sensors was presented. In order to maximize the high-dimensional nonlinear cost function appearing in the MLM, an improved alternative projection iteration algorithm, which could optimize the azimuths and direc6on-dependent gain-phase errors was proposed. The closed-form expressions of the Cramér-Rao bound(CRB) for azimuths and gain-phase errors were derived. Simulation experiments show the effectiveness and advantage of the novel method.%针对确定信号模型条件下方位依赖幅相误差的自校正问题,给出了一种基于辅助阵元的方位依赖幅相误差最大似然自校正方法;针对最大似然估计器中出现的高维非线性优化问题,推导了一种改进型交替投影迭代算法,从而实现了信号方位和方位依赖幅相误差的优化计算.此外,还推导了信号方位和方位依赖幅相误差的无偏克拉美罗界(CRB).仿真实验结果验证了新方法的有效性和优越性.

  14. Langkawi Island, Social Aspect and the Carrying Capacity

    OpenAIRE

    Mohamad Diana; Jaafar Mastura; Marzuki Azizan

    2014-01-01

    The aptitude to convince a range of preferences has facilitated the island tourism attractions to achieve international recognition and at present KILIM Geopark is enjoyed by a prominent percentage of individuals wide-reaching. Conventional knowledge has that the island attractions are operating on the limited immobile resources, of which, have raised the scholars’ concerns over the carrying capacity issue. When analyzing carrying capacity, scholars have traditionally focused on the environme...

  15. The Construction of Social Darwinism in Sister Carrie

    Institute of Scientific and Technical Information of China (English)

    薛晶晶; 秦素华

    2014-01-01

    Social Darwinism is an important theory reflected in Sister Carrie. This thesis is to interpret the characters’fates with Social Darwinism.“Survival of the fittest”is an important theme. Carrie is the winner of life and Hurtwood is the loser. Their adjustability to the environment determines their future. It is hoped to help the readers construct a better understanding on this theory.

  16. Design and Implementation of High Speed Carry Select Adder

    OpenAIRE

    B. Gopinath; N Sangeetha; S.Jenifer nancy; T.Umarani

    2015-01-01

    In electronic adder is a digital circuit that performs addition of numbers. Adders can be constructed for many numerical representations such as arithmetic and logical operation. The most adders operates on binary numbers. Among the different types of adders, carry select adder is a one of the fastest adder.The gate level modification is to reduce the power and area of carry select adder by using the concept of Arithmetic Logic Unit (ALU). In this paper , different techniques such as Binary T...

  17. Challenges and Applications of the Transtheoretical Model in Patients with Diabetes Mellitus

    OpenAIRE

    2008-01-01

    The transtheoretical model of behavior change has become one of the most influential theoretical models within health psychology. Characterized by treating behavior change as a dynamic process, it has recently been applied to diabetes mellitus. Both interventional and observational studies have applied the transtheoretical model to the care of patients with diabetes in multiple settings; the studies that have been performed have been very heterogeneous in nature. Pooled data from these studie...

  18. A model program to reduce patient failure to keep scheduled medical appointments.

    Science.gov (United States)

    Schmalzried, Hans D; Liszak, Joseph

    2012-06-01

    Community health center clinics that rely on scheduled appointments lose revenue and time when patients do not keep their appointments. Various approaches have been used to improve the rate of patient appointments kept. This article provides a model intervention program developed by a quality improvement committee at a Northwest Ohio community health center that is credited with significantly reducing rates of patient failure to keep scheduled medical and dental clinic appointments. The approach of this intervention program is different from others in that it was primarily designed to help patients learn how to become part of the solution to the problem. Community health center staff accomplishes this through engaging patients in a respectful and courteous manner and helping them understand the importance of their involvement in maintaining an efficient scheduling process to benefit all patients. Data collected from outpatient appointment records before and after implementation of the program indicate that missed appointments dropped to less than half the pre-intervention rate.

  19. Missile captive carry monitoring using a capacitive MEMS accelerometer

    Science.gov (United States)

    Hatchell, Brian; Mauss, Fred; Santiago-Rojas, Emiliano; Amaya, Ivan; Skorpik, Jim; Silvers, Kurt; Marotta, Steve

    2010-03-01

    Military missiles are exposed to many sources of mechanical vibration that can affect system reliability, safety, and mission effectiveness. One of the most significant exposures to vibration occurs when the missile is being carried by an aviation platform, which is a condition known as captive carry. If the duration of captive carry exposure could be recorded during the missile's service life, several advantages could be realized. Missiles that have been exposed to durations outside the design envelop could be flagged or screened for maintenance or inspection; lightly exposed missiles could be selected for critical mission applications; and missile allocation to missions could be based on prior use to avoid overuse. The U. S. Army Aviation and Missile Research Development and Engineering Center (AMRDEC) has been developing health monitoring systems to assess and improve reliability of missiles during storage and field exposures. Under the direction of AMRDEC staff, engineers at the Pacific Northwest National Laboratory have developed a Captive Carry Health Monitor (CCHM) for the HELLFIRE II missile. The CCHM is an embedded usage monitoring device installed on the outer skin of the HELLFIRE II missile to record the cumulative hours the host missile has been in captive carry mode and thereby assess the overall health of the missile. This paper provides an overview of the CCHM electrical and package design, describes field testing and data analysis techniques used to identify captive carry, and discusses the potential application of missile health and usage data for real-time reliability analysis and fleet management.

  20. Missile Captive Carry Monitoring using a Capacitive MEMS Accelerometer

    Energy Technology Data Exchange (ETDEWEB)

    Hatchell, Brian K.; Mauss, Fredrick J.; Santiago-Rojas, Emiliano; Amaya, Ivan A.; Skorpik, James R.; Silvers, Kurt L.; Marotta, Steve

    2010-04-08

    Military missiles are exposed to many sources of mechanical vibration that can affect system reliability, safety, and mission effectiveness. One of the most significant exposures to vibration occurs when the missile is being carried by an aviation platform, which is a condition known as captive carry. If the duration of captive carry exposure could be recorded during the missile’s service life, several advantages could be realized. Missiles that have been exposed to durations outside the design envelop could be flagged or screened for maintenance or inspection; lightly exposed missiles could be selected for critical mission applications; and missile allocation to missions could be based on prior use to avoid overuse. The U. S. Army Aviation and Missile Research Development and Engineering Center (AMRDEC) has been developing health monitoring systems to assess and improve reliability of missiles during storage and field exposures. Under the direction of AMRDEC staff, engineers at the Pacific Northwest National Laboratory have developed a Captive Carry Health Monitor (CCHM) for the HELLFIRE II missile. The CCHM is an embedded usage monitoring device installed on the outer skin of the HELLFIRE II missile to record the cumulative hours the host missile has been in captive carry mode and thereby assess the overall health of the missile. This paper provides an overview of the CCHM electrical and package design, describes field testing and data analysis techniques used to identify captive carry, and discusses the potential application of missile health and usage data for real-time reliability analysis and fleet management.

  1. Carrying capacity: the tradition and policy implications of limits

    Directory of Open Access Journals (Sweden)

    Virginia Deane Abernethy

    2001-01-01

    Full Text Available ABSTRACT: Within just the last few centuries, science and technology have enlarged human capabilities and population size until humans now take, for their own use, nearly half of the Earth's net terrestrial primary production. An ethical perspective suggests that potentials to alter, or further increase, humanity's use of global resources should be scrutinized through the lenses of self-interested foresightedness and respect for non-human life. Without overtly invoking ethics, studies of the carrying capacity achieve just this objective. Carrying capacity is an ecological concept that expresses the relationship between a population and the natural environment on which it depends for ongoing sustenance. Carrying capacity assumes limits on the number of individuals that can be supported at a given level of consumption without degrading the environment and, therefore, reducing future carrying capacity. That is, carrying capacity addresses long-term sustainability. Worldviews differ in the importance accorded to the carrying capacity concept. This paper addresses three worldviews - ecological, romantic, and entrepreneurial - and explores the ethics and the policy implications of their contrasting perspectives.

  2. The Broken American Dream Based on Sister Carrie

    Institute of Scientific and Technical Information of China (English)

    Dong Wenjuan

    2012-01-01

      Sister Carrie is the first work of Theodore Dreiser, It tells us how a country maiden becomes a famous star in Broadway. In the novel, Dreiser describes the living conditions and emotion changes of Carrie very vividly. Sister Carrie takes true realism as its distinctive feature, reflects the tragic fact that people pursue American dream fanatically in the early twentieth century. This paper exposes the theme of instinct, which drives people to enjoy but disillusion finally, and illustrates that it is impossible to possess true happiness in a money-oriented capitalism society%  Sister Carrie is the first work of Theodore Dreiser, Ittells us how a country maiden becomes a famous star in Broadway.In the novel, Dreiser describes the living conditions and emotion changes of Carrie very vividly. Sister Carrie takes true realism as itsdistinctive feature, reflects the tragic fact that people pursue Americandream fanatically in the early twentieth century. This paper exposes the theme of instinct, which drives people to enjoy but disillusion finally, and illustrates that it is impossible to possess true happiness in a money-oriented capitalism society

  3. Integrated Coastal Zone Planning Based on Environment Carrying Capacity Analysis

    Science.gov (United States)

    Miharja, M.; Arsallia, S.

    2017-07-01

    Coastal zone is a crucial area in terms of planning development. It holds high economic value, which affect to increasing number of inhabitants living in the area. As a result, this condition influences environmental degradation. Thus, in every attempt towards coastal zone development, it is crucial to always refer to environment carrying capacity. Carrying capacity is the limit of a certain coastal zone capability to support all human created activities, in which all ecological performances are maintained at sustainable level. The failure to establish strong and clear method and regulation on carrying capacity analysis will lead to a very risky coastal zone development, which in turn would threat the area’s sustainability. This paper discusses method for analysing carrying capacity of coastal zone as important input for the area development plan. Two key parameters, i.e. land and clean water carrying capacities are discussed to form carrying capacity analytical method. Furthermore, an empirical data of Ambon Bay, Moluccas Province, is used to illustrate the operationalization of the method.

  4. Review of modeling approaches for emergency department patient flow and crowding research.

    Science.gov (United States)

    Wiler, Jennifer L; Griffey, Richard T; Olsen, Tava

    2011-12-01

    Emergency department (ED) crowding is an international phenomenon that continues to challenge operational efficiency. Many statistical modeling approaches have been offered to describe, and at times predict, ED patient load and crowding. A number of formula-based equations, regression models, time-series analyses, queuing theory-based models, and discrete-event (or process) simulation (DES) models have been proposed. In this review, we compare and contrast these modeling methodologies, describe the fundamental assumptions each makes, and outline the potential applications and limitations for each with regard to usability in ED operations and in ED operations and crowding research. © 2011 by the Society for Academic Emergency Medicine.

  5. A clinical model for quality of life assessment in cancer patients receiving chemotherapy.

    Science.gov (United States)

    Klee, M C; King, M T; Machin, D; Hansen, H H

    2000-01-01

    The pattern of symptoms experienced by cancer patients during chemotherapy is very complex. Consequently, quality of life (QOL) assessment has to be carefully planned to capture clinically relevant changes. A clinical model of changes in symptoms experienced by symptomatic metastatic patients during several courses of chemotherapy has been developed. The model differentiates cancer-related symptoms, acute side-effects, chronic side-effects and symptoms not related to cancer. The model was used to predict changes in each of these four symptom groups. Three time points were selected (post-cycle 2, pre-cycle 3, post-cycle 5) and an appropriate window around each time point was set. The model predictions were tested empirically with 56 patients with advanced ovarian cancer who completed the EORTC QLQ-C30 plus disease specific items during a six-cycle course of chemotherapy. The changes observed in the sample were in accordance with the changes predicted by the clinical model. Results from patients who did not complete the questionnaire within the specified time windows tended to dilute the findings from the group who did. A clinical model is useful in the planning of QOL assessments in order to capture clinically relevant effects. Such models also facilitate the interpretation of QOL studies, particularly when cyclic short-term effects and chronic side-effects are overlaid on disease symptoms, as is the case with chemotherapy for cancer.

  6. Patient-Specific Predictive Modeling Using Random Forests: An Observational Study for the Critically Ill

    Science.gov (United States)

    2017-01-01

    Background With a large-scale electronic health record repository, it is feasible to build a customized patient outcome prediction model specifically for a given patient. This approach involves identifying past patients who are similar to the present patient and using their data to train a personalized predictive model. Our previous work investigated a cosine-similarity patient similarity metric (PSM) for such patient-specific predictive modeling. Objective The objective of the study is to investigate the random forest (RF) proximity measure as a PSM in the context of personalized mortality prediction for intensive care unit (ICU) patients. Methods A total of 17,152 ICU admissions were extracted from the Multiparameter Intelligent Monitoring in Intensive Care II database. A number of predictor variables were extracted from the first 24 hours in the ICU. Outcome to be predicted was 30-day mortality. A patient-specific predictive model was trained for each ICU admission using an RF PSM inspired by the RF proximity measure. Death counting, logistic regression, decision tree, and RF models were studied with a hard threshold applied to RF PSM values to only include the M most similar patients in model training, where M was varied. In addition, case-specific random forests (CSRFs), which uses RF proximity for weighted bootstrapping, were trained. Results Compared to our previous study that investigated a cosine similarity PSM, the RF PSM resulted in superior or comparable predictive performance. RF and CSRF exhibited the best performances (in terms of mean area under the receiver operating characteristic curve [95% confidence interval], RF: 0.839 [0.835-0.844]; CSRF: 0.832 [0.821-0.843]). RF and CSRF did not benefit from personalization via the use of the RF PSM, while the other models did. Conclusions The RF PSM led to good mortality prediction performance for several predictive models, although it failed to induce improved performance in RF and CSRF. The distinction

  7. The Effect of Partnership Care Model on Mental Health of Patients with Thalassemia Major

    Directory of Open Access Journals (Sweden)

    Afzal Shamsi

    2017-01-01

    Full Text Available Background. Thalassemia major has become a public health problem worldwide, particularly in developing and poor countries, while the role of educating the family and community has not been considered enough in patients’ care. Objectives. This study examines the impact of partnership care model on mental health of patients with beta-thalassemia major. Materials and Methods. This experimental study, with pretest and posttest design, was performed on patients with beta-thalassemia major in Jiroft city. 82 patients with beta-thalassemia major were allocated randomly into two groups of intervention (41 patients and control (n=41 groups. Mental health of the participants was measured using the standard questionnaire GHQ-28 before and after intervention in both groups. The intervention was applied to the intervention group for 6 months, based on the partnership care model. Results. There were significant differences between the scores of mental health and its subscales between two groups after the intervention (P<0.05. Conclusions. The findings of the study revealed the efficacy and usefulness of partnership care model on mental health of patients with beta-thalassemia major; thus, implementation of this model is suggested for the improvement of mental health of patients with beta-thalassemia major.

  8. [Training model for integral treatment of patients with eating disorders resistant to change].

    Science.gov (United States)

    Calvo Sagardoy, R; Gallego Morales, L T; García de Lorenzo y Mateos, A

    2012-01-01

    The need to find effective treatments for patients with Anorexia or Bulimia nervosa has led to the professionals who care for them to develop new forms of treatment that take into account the variables that cause resistance to change. Patients in this study (2006-2009) have the following characteristics: 340 patients who have 7 or more years of evolution and/or have tried numerous previous treatments without having succeeded in starting and / or maintaining the desired changes, that allowed them to recover steadily. As the proposed treatment, the patient-treatment team is based on the principles of the training model. It considers the patient holistically, it informs and provides him with resources to increase its commitment to change. Teaches the patient to take care physically and mentally as a way to regain their health and leave the disorder in a stable way. Includes family members as essential support in the recovery of their closest. Therapists require extensive experience in the treatment of ED, flexibility, ability to integrate with other team members even if they use different theoretical models, skills for group sessions, ability to handle negative emotions and frustration tolerance. Finally, the model presented below has been implemented, recovered patients whose stay in the disorder exceeded 15 years of development and led to permanent occupational disability.

  9. Strategic level proton therapy patient admission planning: a Markov decision process modeling approach.

    Science.gov (United States)

    Gedik, Ridvan; Zhang, Shengfan; Rainwater, Chase

    2016-01-25

    A relatively new consideration in proton therapy planning is the requirement that the mix of patients treated from different categories satisfy desired mix percentages. Deviations from these percentages and their impacts on operational capabilities are of particular interest to healthcare planners. In this study, we investigate intelligent ways of admitting patients to a proton therapy facility that maximize the total expected number of treatment sessions (fractions) delivered to patients in a planning period with stochastic patient arrivals and penalize the deviation from the patient mix restrictions. We propose a Markov Decision Process (MDP) model that provides very useful insights in determining the best patient admission policies in the case of an unexpected opening in the facility (i.e., no-shows, appointment cancellations, etc.). In order to overcome the curse of dimensionality for larger and more realistic instances, we propose an aggregate MDP model that is able to approximate optimal patient admission policies using the worded weight aggregation technique. Our models are applicable to healthcare treatment facilities throughout the United States, but are motivated by collaboration with the University of Florida Proton Therapy Institute (UFPTI).

  10. Modeling using clinical examination indicators predicts interstitial lung disease among patients with rheumatoid arthritis

    Science.gov (United States)

    Wang, Yao; Song, Wuqi; Wu, Jing; Li, Zhangming; Mu, Fengyun; Li, Yang; Huang, He; Zhu, Wenliang

    2017-01-01

    Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA) that is well-defined as a chronic systemic autoimmune disease. A proportion of patients with RA-associated ILD (RA-ILD) develop pulmonary fibrosis (PF), resulting in poor prognosis and increased lifetime risk. We investigated whether routine clinical examination indicators (CEIs) could be used to identify RA patients with high PF risk. A total of 533 patients with established RA were recruited in this study for model building and 32 CEIs were measured for each of them. To identify PF risk, a new artificial neural network (ANN) was built, in which inputs were generated by calculating Euclidean distance of CEIs between patients. Receiver operating characteristic curve analysis indicated that the ANN performed well in predicting the PF risk (Youden index = 0.436) by only incorporating four CEIs including age, eosinophil count, platelet count, and white blood cell count. A set of 218 RA patients with healthy lungs or suffering from ILD and a set of 87 RA patients suffering from PF were used for independent validation. Results showed that the model successfully identified ILD and PF with a true positive rate of 84.9% and 82.8%, respectively. The present study suggests that model integration of multiple routine CEIs contributes to identification of potential PF risk among patients with RA.

  11. Applying the domain management model in treating patients with chronic diseases.

    Science.gov (United States)

    Siebens, H

    2001-06-01

    In the health care system in the United States, the management of chronic health conditions and their functional consequences challenge and frustrate patients, caregivers/families, health care providers, and physicians. Contributing factors include a lack of physician and health care provider training and a health system that emphasizes diagnosis and management of acute illnesses. A broader patient care model is required for patients with chronic disease(s). USING THE DOMAIN MANAGEMENT MODEL (DMM) TO CLASSIFY PATIENTS' CLINICAL PROBLEMS: The DMM is a synthesis of approaches used in internal medicine, geriatric medicine, and physical medicine and rehabilitation. All clinical problems, their treatments, and their outcomes can be classified and followed over time in a multiaxial model with four domains-medical/surgical issues, mental status/emotions/coping, physical function, and living environment. Use of the four domain headings in standard templates can lead to an improved awareness of all the relevant issues in the management of chronic illnesses. This awareness precedes a physician's implementation of better care processes. Also, good patient care decisions require good information. The DMM can be used to educate care providers and organize care in terms of important and common functional problem (for example, trouble walking, which lacks a standard approach in health care). This common framework for the organization, documentation, and communication of patients' care over time will help teach systematic mangement of chronic health conditions and help with future research on complex patient management.

  12. Evaluation of radioprotection conditions and patient dose in thorax exams carried out in a public children's hospital in Belo Horizonte, MG, Brazil; Avaliacao das condicoes de radioprotecao e dose paciente em exames de torax realizados em um hospital publico infantil de Belo Horizonte, MG

    Energy Technology Data Exchange (ETDEWEB)

    Lacerda, Marco A.S.; Silva, Teogenes A. da; Guedes, Elton C. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Khoury, Helen J. [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil); Azevedo, Ana C.P. [Fundacao Oswaldo Cruz (ENSP-CESTEH), Rio de Janeiro, RJ (Brazil)

    2005-07-01

    We conducted a survey of the conditions of radiation protection, radiographic techniques, dose and risk for pediatric patients undergoing chest X-rays exams in a children's hospital in Belo Horizonte-MG, Brazil. From a total of 125 chest exams (projections AP and PA) were noted the patient data (gender, weight, and age) and parameters of radiographic technique (kV, mAs and distance focus-skin). I was also evaluated the working procedures and the conditions of radiation protection. The values of input air kerma (K{sub a,e}) and effective dose (E) were determined using the DoseCal software developed by Radiological Protection Center of Saint Georges's Hospital in London. With respect to the procedures and conditions for radiation protection, many aspects of Portaria 453 are not considered. The use of radiographic techniques with high values of mAs and low voltage values are not according with the quality criteria adopted by the European Community (EC). The values of Ka for patients aged 1 to 5 years varied between 51 {mu}Gy and 64 {mu}Gy, below the reference levels proposed by the EC. For patients over 5 years old, the values of Ka were substantially higher than those for other patients. The results allow to conclude that there is a need for optimization of the procedures adopted in order to reduce the dose and the risk to patients.

  13. Patient-specific pediatric silicone heart valve models based on 3D ultrasound

    Science.gov (United States)

    Ilina, Anna; Lasso, Andras; Jolley, Matthew A.; Wohler, Brittany; Nguyen, Alex; Scanlan, Adam; Baum, Zachary; McGowan, Frank; Fichtinger, Gabor

    2017-03-01

    PURPOSE: Patient-specific heart and valve models have shown promise as training and planning tools for heart surgery, but physically realistic valve models remain elusive. Available proprietary, simulation-focused heart valve models are generic adult mitral valves and do not allow for patient-specific modeling as may be needed for rare diseases such as congenitally abnormal valves. We propose creating silicone valve models from a 3D-printed plastic mold as a solution that can be adapted to any individual patient and heart valve at a fraction of the cost of direct 3D-printing using soft materials. METHODS: Leaflets of a pediatric mitral valve, a tricuspid valve in a patient with hypoplastic left heart syndrome, and a complete atrioventricular canal valve were segmented from ultrasound images. A custom software was developed to automatically generate molds for each valve based on the segmentation. These molds were 3D-printed and used to make silicone valve models. The models were designed with cylindrical rims of different sizes surrounding the leaflets, to show the outline of the valve and add rigidity. Pediatric cardiac surgeons practiced suturing on the models and evaluated them for use as surgical planning and training tools. RESULTS: Five out of six surgeons reported that the valve models would be very useful as training tools for cardiac surgery. In this first iteration of valve models, leaflets were felt to be unrealistically thick or stiff compared to real pediatric leaflets. A thin tube rim was preferred for valve flexibility. CONCLUSION: The valve models were well received and considered to be valuable and accessible tools for heart valve surgery training. Further improvements will be made based on surgeons' feedback.

  14. Explanatory Models and Medication Adherence in Patients with Depression in South India

    Science.gov (United States)

    Siddappa, Adarsh Lakkur; Raman, Rajesh; Hattur, Basavana Gowdappa

    2017-01-01

    Introduction Conceptualization of depression may have bearing on treatment seeking. It may affect adherence behaviour of the patients. Aim To find out the explanatory models and their relationship with socio-demographic variables and medication adherence in patients with depression. Materials and Methods Fifty-eight consecutive patients with depression in remission were recruited as per selection criteria. Socio-demographic details were collected. Patients were assessed using Mental Distress Explanatory Model Questionnaire (MDEMQ) and Morisky Medication Adherence Scale (MMAS). Results Significant scores were observed in all dimensions of explanatory models. In the Mann-Whitney U test the patient’s marital status (MU=113.500, p=0.05, sig≤0.05, 2-tailed), and family history of mental illness (MU=165.5, p=0.03, sig≤0.05, 2-tailed) had a statistically significant group difference in the score of MDEMQ. In linear regression analysis, four predictors (MDEMQ subscales Stress, Western physiology, Non-Western physiology and Supernatural) had significantly predicted the value of MMAS (R2=0.937, f=153.558, p<0.001). Conclusion Findings of this study suggested that patients with depression harbor multidimensional explanatory model. The levels of explanatory models are inversely associated with levels of medication adherence. PMID:28274025

  15. Minimally Disruptive Medicine: A Pragmatically Comprehensive Model for Delivering Care to Patients with Multiple Chronic Conditions.

    Science.gov (United States)

    Leppin, Aaron L; Montori, Victor M; Gionfriddo, Michael R

    2015-01-29

    An increasing proportion of healthcare resources in the United States are directed toward an expanding group of complex and multimorbid patients. Federal stakeholders have called for new models of care to meet the needs of these patients. Minimally Disruptive Medicine (MDM) is a theory-based, patient-centered, and context-sensitive approach to care that focuses on achieving patient goals for life and health while imposing the smallest possible treatment burden on patients' lives. The MDM Care Model is designed to be pragmatically comprehensive, meaning that it aims to address any and all factors that impact the implementation and effectiveness of care for patients with multiple chronic conditions. It comprises core activities that map to an underlying and testable theoretical framework. This encourages refinement and future study. Here, we present the conceptual rationale for and a practical approach to minimally disruptive care for patients with multiple chronic conditions. We introduce some of the specific tools and strategies that can be used to identify the right care for these patients and to put it into practice.

  16. Bullying and weapon carrying: a meta-analysis.

    Science.gov (United States)

    van Geel, Mitch; Vedder, Paul; Tanilon, Jenny

    2014-08-01

    Studies suggest that adolescents involved in bullying are more likely to carry weapons than their uninvolved peers. To use meta-analyses to determine whether victims, bullies, and bully-victims are more likely to carry weapons than uninvolved peers. PsycINFO, ERIC, MEDLINE, LILACS, EMBASE, and Dissertation Abstracts International were searched for relevant publications (1950 through January 2014). The reference list of a review article and reference lists of retrieved articles were checked for further relevant studies. Studies were included if they provided an effect size comparing the weapon carrying of adolescent victims, bullies, or bully-victims with that of uninvolved peers. Studies that included individuals older than 21 years were excluded, as were studies that focused on incarcerated youth or youth diagnosed as having a psychopathologic condition. Studies were coded independently by 2 of us. The agreement rate was 93%. Effect sizes were coded that compared victims, bullies, or bully-victims with uninvolved peers. Meta-analyses were based on 22 studies for victims (n = 257 179), 15 studies for bullies (n = 236 145), and 8 studies for bully-victims (n = 199 563). This study focused on weapon carrying among adolescents. Hypotheses were formulated before the study. Victims (odds ratio, 1.97; 95% CI, 1.62-2.39), bullies (3.25; 2.72-3.89), and bully-victims (4.95; 3.77-6.50) were more likely to carry weapons than uninvolved peers. Analyses provided no indication of publication bias. Studies conducted in the United States found stronger relations between being a bully-victim and weapon carrying (odds ratio, 7.84; 95% CI, 6.02-10.21) than studies from other countries (3.62; 2.30-5.68; Q1 = 8.401; P = .004). Involvement in bullying as a victim, bully, or bully-victim is related to weapon carrying.

  17. Modeling the oxygen uptake kinetics during exercise testing of patients with chronic obstructive pulmonary diseases using nonlinear mixed models

    DEFF Research Database (Denmark)

    Baty, Florent; Ritz, Christian; van Gestel, Arnoldus

    2016-01-01

    regression. Simultaneous modeling of multiple kinetics requires nonlinear mixed models methodology. To the best of our knowledge, no such curve-fitting approach has been used to analyze multiple [Formula: see text]O2 kinetics in both research and clinical practice so far. METHODS: In the present study, we...... describe functionality of the R package medrc that extends the framework of the commonly used packages drc and nlme and allows fitting nonlinear mixed effects models for automated nonlinear regression modeling. The methodology was applied to a data set including 6MWT [Formula: see text]O2 kinetics from 61...... patients with chronic obstructive pulmonary disease (disease severity stage II to IV). The mixed effects approach was compared to a traditional curve-by-curve approach. RESULTS: A six-parameter nonlinear regression model was jointly fitted to the set of [Formula: see text]O2 kinetics. Significant...

  18. Modeling the oxygen uptake kinetics during exercise testing of patients with chronic obstructive pulmonary diseases using nonlinear mixed models

    DEFF Research Database (Denmark)

    Baty, Florent; Ritz, Christian; van Gestel, Arnoldus;

    2016-01-01

    regression. Simultaneous modeling of multiple kinetics requires nonlinear mixed models methodology. To the best of our knowledge, no such curve-fitting approach has been used to analyze multiple [Formula: see text]O2 kinetics in both research and clinical practice so far. METHODS: In the present study, we...... describe functionality of the R package medrc that extends the framework of the commonly used packages drc and nlme and allows fitting nonlinear mixed effects models for automated nonlinear regression modeling. The methodology was applied to a data set including 6MWT [Formula: see text]O2 kinetics from 61...... patients with chronic obstructive pulmonary disease (disease severity stage II to IV). The mixed effects approach was compared to a traditional curve-by-curve approach. RESULTS: A six-parameter nonlinear regression model was jointly fitted to the set of [Formula: see text]O2 kinetics. Significant...

  19. Determinants of quality of life in patients with fibromyalgia: A structural equation modeling approach

    Science.gov (United States)

    Lee, Jeong-Won; Lee, Kyung-Eun; Park, Dong-Jin; Kim, Seong-Ho; Nah, Seong-Su; Lee, Ji Hyun; Kim, Seong-Kyu; Lee, Yeon-Ah; Hong, Seung-Jae; Kim, Hyun-Sook; Lee, Hye-Soon; Kim, Hyoun Ah; Joung, Chung-Il; Kim, Sang-Hyon

    2017-01-01

    Objective Health-related quality of life (HRQOL) in patients with fibromyalgia (FM) is lower than in patients with other chronic diseases and the general population. Although various factors affect HRQOL, no study has examined a structural equation model of HRQOL as an outcome variable in FM patients. The present study assessed relationships among physical function, social factors, psychological factors, and HRQOL, and the effects of these variables on HRQOL in a hypothesized model using structural equation modeling (SEM). Methods HRQOL was measured using SF-36, and the Fibromyalgia Impact Questionnaire (FIQ) was used to assess physical dysfunction. Social and psychological statuses were assessed using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Arthritis Self-Efficacy Scale (ASES), and the Social Support Scale. SEM analysis was used to test the structural relationships of the model using the AMOS software. Results Of the 336 patients, 301 (89.6%) were women with an average age of 47.9±10.9 years. The SEM results supported the hypothesized structural model (χ2 = 2.336, df = 3, p = 0.506). The final model showed that Physical Component Summary (PCS) was directly related to self-efficacy and inversely related to FIQ, and that Mental Component Summary (MCS) was inversely related to FIQ, BDI, and STAI. Conclusions In our model of FM patients, HRQOL was affected by physical, social, and psychological variables. In these patients, higher levels of physical function and self-efficacy can improve the PCS of HRQOL, while physical function, depression, and anxiety negatively affect the MCS of HRQOL. PMID:28158289

  20. Developing and Validating a Survival Prediction Model for NSCLC Patients Through Distributed Learning Across 3 Countries.

    Science.gov (United States)

    Jochems, Arthur; Deist, Timo M; El Naqa, Issam; Kessler, Marc; Mayo, Chuck; Reeves, Jackson; Jolly, Shruti; Matuszak, Martha; Ten Haken, Randall; van Soest, Johan; Oberije, Cary; Faivre-Finn, Corinne; Price, Gareth; de Ruysscher, Dirk; Lambin, Philippe; Dekker, Andre

    2017-10-01

    Tools for survival prediction for non-small cell lung cancer (NSCLC) patients treated with chemoradiation or radiation therapy are of limited quality. In this work, we developed a predictive model of survival at 2 years. The model is based on a large volume of historical patient data and serves as a proof of concept to demonstrate the distributed learning approach. Clinical data from 698 lung cancer patients, treated with curative intent with chemoradiation or radiation therapy alone, were collected and stored at 2 different cancer institutes (559 patients at Maastro clinic (Netherlands) and 139 at Michigan university [United States]). The model was further validated on 196 patients originating from The Christie (United Kingdon). A Bayesian network model was adapted for distributed learning (the animation can be viewed at https://www.youtube.com/watch?v=ZDJFOxpwqEA). Two-year posttreatment survival was chosen as the endpoint. The Maastro clinic cohort data are publicly available at https://www.cancerdata.org/publication/developing-and-validating-survival-prediction-model-nsclc-patients-through-distributed, and the developed models can be found at www.predictcancer.org. Variables included in the final model were T and N category, age, performance status, and total tumor dose. The model has an area under the curve (AUC) of 0.66 on the external validation set and an AUC of 0.62 on a 5-fold cross validation. A model based on the T and N category performed with an AUC of 0.47 on the validation set, significantly worse than our model (P<.001). Learning the model in a centralized or distributed fashion yields a minor difference on the probabilities of the conditional probability tables (0.6%); the discriminative performance of the models on the validation set is similar (P=.26). Distributed learning from federated databases allows learning of predictive models on data originating from multiple institutions while avoiding many of the data-sharing barriers. We believe